When the “Gift of Life” Costs More Than Expected: Ethical Considerations for First Person Authorizations of Organ Donation

There has been significant concern surrounding the procedures and conditions for donation after circulatory death (DCD). As organ procurement organizations face increased pressure, there have been conflicts and concerns over the expectations for how patients who have designated themselves as donors are treated prior to death, and at the time of the withdrawal of life sustaining treatment. This session will describe the effects and limitations of “first person authorizations” (FPAs) for donation, and how unresolved questions about the scope of FPA can lead to conflict over how and when life sustaining treatment is withdrawn, conflict over treatments for living patients designed to improve organ procurement but not the patient’s medical interests, and confusion about the kinds of information that should be disclosed to patients or their loved ones prior to organ procurement.