Saying goodbye to a deceased person before their organ(s) are donated

Doctors must make every possible effort to save the patient’s life. That is their first duty. If, despite their efforts, the patient dies, cause of death is diagnosed by brain stem tests. In the UK, there are very clear and strict standards and procedures for doing these tests. They are always performed by two experienced doctors who are completely independent of the transplant team. Death is confirmed in the same way for people who choose to donate their organs as for those who do not. It is around this time that the question of organ donation is raised, and the family is given time to come to their decision, within medical constraints (see Consenting to organ donation).

Most organs need to be used very soon after death to ensure they remain suitable for transplantation and the person who has died is not deprived of the opportunity to donate. Once a family had consented to organ donation and accepted that their loved one had died, they said goodbye and then, in most cases, left the hospital. Saying goodbye, understandably, was distressing and traumatic. Added to this was the shock that comes with sudden illness or injury – as this person had been healthy and active only days earlier. Achieving a comfortable and dignified death had been crucial and many relatives had wanted to be present when the patient died. Some people had asked for the hospital chaplain or their own vicar to read the last rites.

Turning off the life support machine involved turning off various switches. It was terrible…

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Haydn cradled his son in his arms as he died, a memory he will always treasure. He was moved to…

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The transplant team gave Frank lots of information. He felt it was his duty, as Jens husband, to…

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The ventilator (life support machine) provides oxygen that keeps the heart beating and blood circulating after death. These donors are called heart beating donors. Organs such as hearts, which deteriorate very quickly without an oxygen supply, are usually only donated by a heart beating donor. Patients who die in hospital but are not on a ventilator can, in some circumstances, donate their kidneys, and in certain circumstances, other organs. They are called non-heart beating donors. Both heart beating and non-heart beating donors can donate their corneas and other tissue.

After saying goodbye to her husband John, Linda asked if she could talk to the transplant surgeon.

The family said goodbye and Linda was the last one to see John. It felt unreal waiting for the…

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Switching off the life support machine was traumatic for some people, and a memory that still haunted a few donor families years later. Saying goodbye to their relative felt shocking and unreal because they ‘looked as if they were just sleeping’. Their body felt warm to the touch, they were breathing, and their skin was a normal colour. The ventilator keeps the body supplied with oxygen so that the heart can carry on beating and circulating blood. This preserves the organs so they can be transplanted.

When the ventilator is turned off, the heart stops beating, usually within a few minutes. The patient is then taken to theatre for surgery. Some people felt that donor families should be told beforehand that their loved one would still be warm and breathing when they said their goodbyes. Craig and Sandra said their daughter Rachel still looked healthy and pink when they said their goodbyes. Leaving her like that was distressing and Craig felt guilty.

Leaving Rachel was heart-wrenching. She looked as if she was sleeping. Her skin was pink, her…

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Liz wishes shed been told beforehand that, with organ donation, a patient continues to breathe…

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For some people, the image of their relative looking as if they were just sleeping was difficult to reconcile with the news they’d been given by doctors. The brain stem tests had proved that they were dead, yet they were still breathing. Tom, John’s stepfather, said he couldn’t accept the job of switching off the ventilator because, years later, he might still question if he’d done the right thing or switched it off too soon.

For Tom, an organ donation death is different from a normal death because a family can be…

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After saying goodbye to their relative, some people had wanted to reassure themselves and to see them in the chapel of rest after the surgery had taken place. Most did feel reassured, though a few were saddened when they went to see their loved one and s/he was alone in a room.

Seeing her son after surgery was traumatic but Lesley never regretted it. It was horrible seeing…

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Sue wanted to see the funeral director to help her accept that her son, Martin, was indeed no longer alive.

Sue asked the funeral director if she could see Martin after hed died. When they left him in ICU…

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Andrea’s brother, Paul, continued breathing for some time after the tube in his mouth had been removed. She worried that organ donation might not be possible even though that had been his wish.

Paul was aware of what was going on right up until the tube was removed. Seeing him at the…

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Some donor families said the specialist nurse (donor coordinator) had asked them if they would like locks of their relative’s hair and handprints. They saw this as a sensitive and caring gesture and valued having them (see Interacting with doctors and nurses in intensive care).

Consenting to organ donation

In England, Scotland and Northern Ireland, organs and tissue from a potential donor can be used only if that is their wish. Joining the NHS...