Organ Donation Decisions in Imminent Death

The organ availability gap is the greatest challenge in making transplantation available to more patients. Some patients near the end of life could become eligible to donate but their surrogate decision-makers choose to terminate support or resuscitation prior to the point of eligibility. While reasons people and families choosenot to be an organ donorare well known, factors leading to the decision not to continue support in imminent death with the possibility of donation have not been described and may be different. These may include the same reasons for not donating organs but might also include social factors made relevant by the inherent waiting time as death ensues-like family dynamics, fatigue, sense of urgency, cost of continuing care, basic needs like lodging and food and other forms of environmental and social support. Through structured interviews, we seek to identify those factors. Then in a larger survey study determine the relative weight of each of the factors contributing to the decision not to wait. These data can then be used to construct family support/care models that encourage donation.