Canadian Journal of Anesthesia

, Volume 50, Issue 9, pp 955–960 | Cite as

Mandatory reporting of “imminent” death to identify organ donors: History, controversy, and potential solutions

Neuroanesthesia and Intensive Care



To review the history of mandatory reporting for the purpose of identifying potential organ and tissue donors, and the controversy around the terms, “imminent” or “impending” death, and to suggest a solution to this controversy.


In this narrative review, published papers were retrieved based on a Medline search using the terms, “mandatory reporting” and “organ donation.” In addition, unpublished data from the United Network for Organ Sharing and the Pennsylvania Gift of Life Program were reviewed.

Principal findings

There has been no demonstrable effect of mandatory reporting of “imminent” death independent of educational activities on numbers of organ donors or organs transplanted. Furthermore, mandatory reporting of “imminent” death does not meet criteria of an acceptable screening test.


Education of health care providers about eligibility for organ and tissue donation and about whom to report as a potential donor will hopefully lead to identification of more individuals who meet criteria for organ donation and who will go on to donate organs to the many potential recipients.


Organ Donation Brain Death Tissue Donation Organ Procurement Mandatory Reporting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Déclaration obligatoire de mort “imminente” pour identifier des donneurs d’organes : Histoire, controverse et solutions possibles



Revoir l’historique d’une déclaration obligatoire visant à identifier des donneurs d’organes et de tissus potentiels et la controverse autour des termes de mort “imminente” ou “annoncée” et suggérer une solution.


Dans cette revue descriptive, des articles publiés ont été extraits de la base de Medline à partir des termes “mandatory reporting” et “organ donation”. Nous avons aussi passé en revue les données non publiées du United Network for Organ Sharing et du Pennsylvania Gift of Life Program.

Constatations principales

Il n’y a pas d’effet démontrable de la notification obligatoire de mort “imminente”, indépendante des activités pédagogiques, sur le nombre de donneurs d’organes ou d’organes transplantés. De plus, l’obligation de déclarer la mort “imminente” ne répond pas au critère d’un test de dépistage ou d’un procédé de sélection acceptable.


La formation des prestateurs de soins sur l’admissibilité d’un don d’organe et de tissus et sur les gens reconnus comme donneurs potentiels devrait, espérons-le, conduire à l’identification de plus d’individus, répondant aux critères de don d’organe, qui acceptent de faire un don aux nombreux receveurs potentiels.


  1. 1.
    Ross SE, Nathan H, O’Malley KF. Impact of a required request law on vital organ procurement. J Trauma 1990; 30: 820–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Norris MK. Required request: why it has not significantly improved the donor shortage (Editorial). Heart Lung 1990; 19: 685–6.PubMedGoogle Scholar
  3. 3.
    Gaber AO, Hall G, Britt LG. An assessment of the impact of required request legislation on the availability of cadaveric organs for transplantation. Transplant Proc 1990; 22: 318–9.PubMedGoogle Scholar
  4. 4.
    Siminoff LA, Arnold RM, Caplan AL, Virnig BA, Seltzer DL. Public policy governing organ and tissue procurement in the United States. Results from the national organ and tissue procurement study. Ann Intern Med 1995; 123: 10–7.PubMedGoogle Scholar
  5. 5.
    Caplan AL, Virnig B. Is altruism enough? Required request and the donation of cadaver organs and tissues in the United States. Crit Care Clin 1990; 6: 1007–18.PubMedGoogle Scholar
  6. 6.
    Martyn S, Wright R, Clark L. Required request for organ donation: moral, clinical, and legal problems. Hastings Cent Rep 1988; 18: 27–34.PubMedGoogle Scholar
  7. 7.
    Spital A. Mandated choice. The preferred solution to the organ shortage? Arch Intern Med 1992; 152: 2421–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Spital A. Mandated choice. A plan to increase public commitment to organ donation. JAMA 1995; 273: 504–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Council on Ethical and Judicial affairs, American medical association. Strategies for cadaveric organ procurement. Mandated choice and presumed consent. JAMA 1994; 272: 809–12.CrossRefGoogle Scholar
  10. 10.
    Arnold RM, Siminoff LA, Frader JE. Ethical issues in organ procurement. A review for intensivists. Crit Care Med 1996; 12: 29–48.Google Scholar
  11. 11.
    Herz SE. Two Steps to three choices: a new approach to mandated choice. Camb Q Healthc Ethics 1999; 8: 340–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Pollard S. The impact of state legislation on organ donation-results of a US pilot scheme. Nephrol Dial Transplant 1997; 12: 2510–1.PubMedCrossRefGoogle Scholar
  13. 13.
    Identification of potential organ, tissue, and eye donors. Questions and answers. Scholar
  14. 14.
    UNOS 2001 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry for Transplant Recipients: transplant Data 1991–2000. Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation, Rockville, MD; United Network for Organ Sharing, Richmond, VA; University Renal Research and Education Association, Ann Arbor, MI.Google Scholar
  15. 15.
    Marks WH. Participating in organ and tissue donation. Surgical Services Management 1999; 5: 48–50.Google Scholar
  16. 16.
    Wilson JMG, Jungner G. Principles and Practice of Screening for Disease. World Health Organ; 1968.Google Scholar
  17. 17.
    Woolf HB. The Miriam-Webster Dictionary. New York: Pocket Books; 1974.Google Scholar

Copyright information

© Canadian Anesthesiologists 2003

Authors and Affiliations

  1. 1.Program of Critical Care Medicine and Centre for Health Evaluation and Outcome SciencesSt. Paul’s Hospital and University of British ColumbiaVancouverCanada

Personalised recommendations