When a loved one is critically ill, families may have questions about how decisions are made, especially when organ donation becomes a possibility.
One question we sometimes hear is: Who decides when a patient has died?
The patient’s medical team determines and declares death through a series of clinical tests. Organ Procurement Organizations (OPOs), like HonorBridge, do not declare death.
This distinction is an important part of the donation process and is required by federal and state law. The hospital medical team caring for a patient makes that decision independently from the organ donation team. Only after death has been declared by hospital doctors can donation be considered.
Why does this separation matter?
“This separation is intentional,” says Dr. Tom Nakagawa, Medical Director at HonorBridge. “It ensures that decisions about a patient’s medical care are made independently of organ donation. According to the legal and ethical standards for organ procurement, recovery cannot result in the death of the patient; recovery can only occur after the patient has been declared dead by their medical team. This separation of roles adheres to the principle of medical care to ‘do no harm’, ensuring patients and the integrity of the donation process are protected.”
When a patient is critically ill, their medical team focuses on providing the best possible care and doing everything they can to restore the health of the patient. Whether someone may be able to donate organs, eyes, or tissue does not change this process.
Physicians and medical teams use established medical and legal standards to determine death. Death can occur if the brain ceases to function or if the heart stops beating. Organ donation can only occur after death has been declared by the patient’s medical team and the patient meets medical suitability criteria for donation determined by the OPO). If the patient signed up to be a donor, their decision is honored. If they had not signed up or if their organ donor status is unknown, the family is provided with the opportunity to make a decision on their loved one’s behalf.
What role does HonorBridge play?
HonorBridge does not determine whether someone is dying or has died.
Our role as the OPO begins when a hospital notifies us that a patient may be a potential donor. We work alongside the hospital team to determine whether donation may be medically possible and support the family through the donation process, providing round-the-clock grief support and education on organ and tissue donation during some of their darkest days.
“I truly take it as an honor and a privilege to sit down with families while they are experiencing one of the hardest days of their lives,” said Leonard Johnson, Family Support Coordinator at HonorBridge. “Any family I come in contact with, I make it very clear that I’m not only a representative of HonorBridge—I look at them as part of my family, too.”
Our teams also coordinate the complex logistics involved in donation, including working with hospitals, transplant centers, funeral homes, and other partners to ensure that organs and tissues can be recovered and transported safely and efficiently to patients on the waiting list.
Donation does not cause death
A patient’s care is always based on what is best for them. Despite what you might have heard, the possibility of donation does not affect decisions about when treatment ends, and donation never causes or speeds up a person’s death. Only after death has been declared can the donation process proceed.
At HonorBridge, we understand that trusting others with your loved one’s care during an incredibly difficult time is significant. That’s why we are committed to transparency, protecting the dignity of every donor, and supporting every family we serve. If you have questions about organ donation, we encourage you to reach out to your local OPO or consult a trusted medical professional.
Donation is made possible because of the generosity of donors and their families. It is never the reason a person dies.
One donor can save and heal up to 75 lives. To learn sign up to be a donor, click here!