Physician Interactions
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Posted 3/7/2009 12:34:20 AM
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Sometimes attendings tell us that they will only perform brain death testing if the family is interested in donation.  What is the best way to communicate the need to perform brain death testing?
Post #74
Posted 3/17/2009 11:18:17 AM
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I have asked our HD specialists to answer this question and will post their different views.  Here is the initial response I received from one:

Brain death is a medical and legal definition for death just as asystole is. That the declaration of brain death or cardiac death, in practice, should be motivated by the exact same outcome; closure to a patient's terminal condition regardless of the potential for organ and tissue donation.

That having been said I believe that many physicians do take the view that BD is really a donation tool not a declaration of death tool.

From personal experience, as a coordinator, I have found that explaining to the physicians that actually having the patient declared (or at least the 1st BDE exam done) gives the family a better understanding of the finality and the physicians explanation of the brain death declaration process allows the family to understand they are not choosing withdraw of support.  It also helps the family be able to move on to considering the opportunity of donation without feeling a conflict with the patients condition.  When I have still met with resistance I have had "Donor Champions" from our other hospitals who understand the importance of declaration of brain death before discussion of donation communicate directly with the "obstructing physicians".  It has made things much easier, I must say even our small hospitals who rarely see donation understand the importance when it is explained right and proceed with declaration before donation approach! 

Hope this helps.

Post #87
Posted 4/1/2009 10:16:38 AM
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Your words are really helpful!  I will be quoting you.
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