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. 2022 Jun;12(2):65-74.
doi: 10.1177/19253621221106892. Epub 2022 Jun 29.

The Intersection of Death Investigation and Organ Donation Systems: A Scoping Review

Mackenzie Cullip, Aimee J Sarti, Matthew J Weiss, Heather Whittingham, Maureen O Meade

The Intersection of Death Investigation and Organ Donation Systems: A Scoping Review

Mackenzie Cullip et al. Acad Forensic Pathol. 2022 Jun.

Abstract

Introduction: Death investigators (DIs) such as coroners, medical examiners, and forensic pathologists play important and evolving roles in deceased organ donation. DIs communicate with organ donation organizations (ODOs) to gather case-specific information and release or restrict organs depending on the medicolegal requirements. This scoping review aims to identify the breadth of roles and decision-making processes that may facilitate or hinder deceased donation in DI cases.

Methods: This study was conducted using a scoping literature review and subsequent thematic analysis.

Results: Thirty-one eligible papers described 8 common themes with region-specific nuances. These include: 1) shared (ODO and DI) protocols for early communication around each case; 2) shared standards and education for death investigation practices related to organ donation; 3) DI support staff or teams to facilitate organ donation; 4) DI authority to order additional testing and imaging before organ recovery; 5) donation-specific legislation to enhance DI and/or ODO operations; 6) legally trained DI authority to veto medical decisions to proceed with organ donation; 7) DI attendance at organ recovery; and 8) surgeons recording specific DI evidence during organ recovery.

Conclusion: These findings have cultural and resource-allocation implications and expose gaps in the international literature describing practices at the intersection of deceased organ donation and death investigation. A better understanding of the rationale and execution of various systems for DI and ODO cooperation may serve to advance both organ donation and death investigation.

Keywords: Coroner; Death investigation; Deceased organ donation; Forensic pathology; Medical examiner; Pathologist.

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Conflict of interest statement

Disclosures & Declaration of Conflicts of Interest: The authors, reviewers, editors, and publication staff do not report any relevant conflicts of interest.

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