We post an ethical or situational concern that has arisen in a facility where one of our readers works. It has no identifiers included. It gives you only the facts of the case. Then, you can respond to that concern. This is an ongoing dialogue, with comments added as they come in. In the following issue, assuming it has been resolved, we give you the outcome from the facility where the incident took place. Please send any cases that you would like considered for inclusion to: info@plainviews.org

We hope that this new addition will help to inform not only those who are dealing with the issue, but will enable all of our readers to learn from the experiences and perhaps mistakes of others.

PLEASE NOTE: Due to unanticipated continuing responses to both the case and the resolution of the case, added responses can be viewed in the archives. Click HERE.

CaseConference #8 Resolution

The patient's uncle saw a sign on the bulletin board from the Organ Donor Network letting the hospital know that a donor's organs had been harvested and had helped several people. He approached the chaplain, pointed to the sign, and asked if his nephew's organs could help others. The chaplain told the uncle that it was possible. The uncle went to his sister, the patient's mother, and told her what he had read and suggested to her that her son's death could provide for others so they could continue to live. After initially giving a definitive "no," the mother walked over to the sign and read it for herself, with her other son translating it for her. The son and mother stood talking and crying for quite a while, pointing to the sign every so often. Eventually, the mother changed her mind and agreed to allow her son to be an organ donor. The Organ Donor Network staff came in, discussed the situation with the mother (in her native tongue) and answered all of the questions that she had. She eventually gave permission and her son's organs were harvested.

At the request of the chaplain, the hospital reviewed its policy about who approaches the family, affirmed their initial policy and held several educational sessions for the staff and doctors to clarify the policy. They also invited the staff from the Organ Donor Network to hold further educational sessions.

CaseConference #8

A 23-year old Hispanic male is brought into the ER unconscious. He is diagnosed with an intracranial hemorrhage which is quickly swelling his brain. There is no chance that he will recover. The family is naturally very distraught. The doctors start talking about organ donation. The chaplain, who has been sitting with the family, is asked to "feel them out" and see if they are willing to allow his organs to be harvested once it is determined that he is brain dead. It is the hospital's policy that the only one who should approach the family is someone from the organ donor network or the attending physician. The attending physician does not speak Spanish and feels uncomfortable broaching the subject with the family since they did not want to believe his original diagnosis and prognosis.

What is the chaplain's role in this situation?

Should the chaplain, who is bi-lingual, be the intermediary?

Are there cultural issues that need to be taken into account?

What takes precedence - the doctors' request or the hospital policy?

Please check the archives below for comments made about the last CaseConference.

Send your comments about CaseConference to info@PlainViews.org.