Just a few days after I had posted a blog about the importance of organ donation and the barriers towards obtaining the consent for donation from the patient’s family, I found myself in a room full of strangers talking about withdrawing life support from their loved one.

The patient was a previously healthy female in her late thirties who was involved in a horrendous car accident. She sustained a severe head injury and remained unresponsive. The CT scan of her brain on day 4 showed extensive cerebral edema and developing infarcts. The prognosis for her neurological recovery was dismal at that point.

From an organ donation standpoint she was a perfect donor – previously healthy and young patient with an isolated head injury.

The family already knew that things were bad. I explained once again what was happening and why their loved one was not going to recover. It seemed like the family had already made up their minds and was considering withdrawal of care.

When I asked about organ donation, the answer was “No we do not want that”. I had to paraphrase the question and asked if the patient would have wanted this if she new that this is going to happen. There was a silence in the room for a few seconds and then one the family members said that she had never put an organ donor sticker on her driver’s license. As I mentioned before, the lack of knowledge about the patient’s own wishes regarding organ donation is one of the barriers towards a successful consent for donation.

I started explaining why organ donation is important and why they should consider it. As I was doing it, I felt uneasy and conflicted. I just told the family that their loved one is not going to get better and now I am trying to get her organs.

I remember some time ago in a similar circumstance, a family member started yelling at me: “You just want to take her organs, that’s why you doing this…”

I have to acknowledge that it almost creates a conflict of interest for the treating physician to approach the family about organ donation. The studies have shown that the success rate for obtaining consent for donation is, actually, higher when somebody independent from the healthcare team approaches the family.

I realize that feeling conflicted about being the treating physician and requesting consent for donation did not allow me to be more persistent with my request. Eventually, I had to acknowledge that the patient was not going to be an organ donor.

This is a very unfortunate situation. One life is lost in a horrible accident, yet we have failed to improve or even save the lives of many other people. Even knowing the barriers for obtaining the consent, I was not able to overcome them.