1. Revising Organ Procurement Organization Guidelines to Obtaining Family Consent for Deceased Donation: An Anthropologically Informed Policy Proposal
- Author:
- Gillian Tisdale
- Publication Date:
- 04-2024
- Content Type:
- Journal Article
- Journal:
- Journal of Public and International Affairs (JPIA)
- Institution:
- School of Public and International Affairs (SPIA), Princeton University
- Abstract:
- Organ transplantation has become a widespread medical practice with public policy designed to increase rates of deceased donation. When individuals have not registered as organ donors, next-of-kin are called on to make donation decisions—requiring families to grapple with the often-confusing concept of ‘brain death’ and parse their understanding of what the deceased would have wanted. Current public policy is explicitly designed to promote high donation rates without clear regard to the experiences of donor-families; at best, these policies prime donation conversations to involve unethical practices, while at worst, the disregard of kin’s experiences may also diminish deceased donation rates. Anthropological literature has documented the often aggressive tactics used by transplant organizations that demonstrate a disregard for the emotional experiences of kin. In 2023, Congress passed the Securing the U.S. Organ Procurement and Transplantation Network Act, prompting the United States Department of Health and Human Services (HHS) to reevaluate organ donation policies and solicit requests for proposal for a new federal contractor to take over the network responsible for overseeing all organ sharing. This article leverages the relevant anthropological literature to provide guiding principles and proposed language amending the Centers for Medicare & Medicaid Services (CMS) Interpretive Guidance that HHS could implement as part of its modernization initiative. These principles aim to improve experiences for kin without lowering donation rates. The article recommends that HHS and its contractors collect metrics to measure the quality of Organ Procurement Organization (OPO) interactions, counterbalancing current benchmarks focused on procurement rates. It also recommends improved protocols to empathically and systematically support kin’s understanding of brain death.
- Topic:
- Legislation, Public Policy, Procurement, and Organ Transplants
- Political Geography:
- North America and United States of America