How should clinicians handle organ donation discussions in end-of-life planning?

• A. Do not discuss organ donation.
• B. Discuss organ donation only if asked by family.
• C. Discuss in alignment with patient values and preferences, including consent processes.
• D. Decide on organ donation without consent.

Answer: (C)

Engaging in end-of-life planning with organ donation requires respecting patient autonomy and ensuring informed consent. The best approach is to discuss organ donation in alignment with the patient’s values and preferences, and to clearly explain the consent processes involved. This ensures that any donation decisions reflect what the patient would want, reduces distress for families during a difficult time, and upholds ethical and legal standards. Clinicians should initiate conversations when appropriate, provide straightforward information about how donation works, and outline who has authority to consent in different situations, including involvement of the organ procurement organization as needed. If the patient has expressed a preference, that choice should guide the discussion and subsequent actions; if not, clinicians should involve the appropriate surrogate and follow established consent procedures. Approaches that avoid the topic, wait for family initiative, or proceed without consent undermine patient autonomy and violate ethical practice.