February 23, 2007 (Orlando) — Despite indicating a wish to be an organ donor on their driver's licenses, 20% of patients' families do not honor those wishes.
A review of records from the North Carolina Department of Motor Vehicles (DMV) shows that a significant number of chances for organ procurement are lost, researchers at the F. H. "Sammy" Ross, Jr, Trauma Center of the Carolinas Healthcare System in Charlotte, North Carolina, reported here this week at the 36th annual meeting of the Society of Critical Care Medicine.
A. Britton Christmas, MD, of the Trauma and Critical Care Unit, and colleagues reviewed 104 organ donation referrals made over a 3-month period to ascertain the appropriateness of the referral for donation, to determine the family's consent or refusal of donation, and to record the number of organs harvested from each donor.
The findings were compared with DMV records for or against organ donation.
Of the 104 referrals, 84 were identified on DMV records and 25 of those were designated as organ donors.
Five families refused to allow organ donation from organ donor designees. The families of 22 of 59 patients not listed as organ donors on DMV records gave consent for organ donation. An average of 3.4 organs were harvested from each eligible donor.
DMV organ donor designation has increased the number of organs available for transplantation, according to the researchers. However, DMV designation is not legally binding, Dr. Christmas reminded meeting attendees, and 20% of families in this review refused to honor the donor's wishes.
"Many family members are hesitant because they don't know the patient's wishes," Dr. Christmas commented. "This can be important to know [ahead of time] because it may affect end-of-life care. Discussion after the fact may not be helpful.
"A lot of individuals are young when they receive their first driver's license, and they don't really know what that means," Dr. Christmas said. "As they get older, they don't remember to update their status and fill out the extra paperwork."
One of the meeting participants noted that Illinois' DMV sends out letters to all drivers when they turn 21 years of age explaining organ donation.
"We routinely access DMV records on our [deceased] patients, and that is becoming the standard of care," Dr. Christmas told Medscape. "It is surprising to us, but not many individuals recognize what being an organ donor is," he added. "Family members must express their wishes to each other, so that donor status is known ahead of time."
Session moderator Kathleen Puntillo, BSN, DNSc, professor of nursing and codirector of the Critical Care/Trauma Unit at the University of California at San Francisco, told Medscpe that "there is a tremendous need for organs.... Education of the families is the key."
Drs. Christmas and Puntillo report no relevant financial relationships.
SCCM 36th Annual Meeting: Poster 523. Presented February 20, 2007.
Medscape Medical News © 2007 Medscape
Cite this: Martha Kerr. Organ Donor Designation on Driver's License Frequently Ignored by Family - Medscape - Feb 23, 2007.