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School aims to boost organ donation in brain-death cases

An Ohio training program says improving physician communication with families is crucial.

By Kevin B. O'Reilly, amednews staff. June 5, 2006.

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It's a challenge any time physicians are called upon to tell family members that a loved one has died, but the challenge is compounded in cases where patients are brain dead.

"Family members don't always understand that brain death is death because the body is still warm and pink while it's on the ventilator," said June Hinkle, RN, director of bereavement services at Ohio State University Hospital.

Sometimes, a doctor will miscommunicate information to a patient's family by saying things such as "He's almost dead," or "He's dead by brain criteria but still breathing," she said. "It's difficult when physicians say those kinds of words to families because they sit there thinking, 'Is he dead or not dead?' "

That's why Hinkle, with $13,000 in grant money from the Ohio Dept. of Health's Second Chance Trust Fund, last year launched a program to train Ohio State University Medical Center residents how to effectively and sensitively communicate with families in brain-death cases.

This program is especially important because the 5% of patients who die by brain-death criteria account for 95% of the organs recovered from deceased donors, according to the U.S. Organ and Procurement Transplant Network. In a healthy person who has died of brain death, up to seven solid organs can be recovered in the hours after death.

Anne Paschke, a spokeswoman at the United Network for Organ Sharing, said the Ohio State program addresses an important problem.

"People understand how death occurs when the heart stops beating," Paschke said. "Brain death is a more difficult concept to convey, and the terminology used can make a huge difference. When people use terms like 'life support,' it sends the wrong message. It doesn't support the message that the patient is dead."