Observations of withdrawal of life-sustaining treatment from patients who became non-heart-beating organ donors

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At the time of non-heart-beating donation’s revival, press reports circulated claiming organ donation was being performed on donors before they had died. This article investigates how to adequately document death and appropriate signs of death before issuing a death certificate. These procedures are especially important in cases of organ donation from non-heart-beating donors where the gap between donor death and organ recovery should be as short as possible. The study found that circulation did not resume after more than one minute of absent circulation, suggesting that two minutes should suffice for certification of death. A few patients had inadequate documentation in their records, which could raise concern for potential abuse. At the time of this article’s 2000 publication, no accepted national standards existed for the certification of death or necessary documentation required for record keeping and oversight existed. These findings demonstrate the need for development of a standardized death certification practice, eliminating any doubt of a patient’s death or the status of a donor at the time of donation.