Family Physicians' Role in Discussing Organ Donation with Patients and the Public
In a small town in Maine, a school board gathered for its monthly meeting. Dr. Gomez, present at the meeting, had practiced family medicine in this town for more than 25 years and his three children had gone through the local school system. Weeks before, a serious car crash involved several high school students and resulted in the death of an 18-year-old boy, Keith. Talk of the crash and death consumed the "new business" portion of the evening. Towards the end of the discussion, a pair of
... on, a pair of parents slowly rose in the back of the gym. "Our daughter Stephanie has been lying in a hospital bed for the past 13 weeks. She is there because she is dying of end-stage liver disease; the only thing that will save her now is a liver transplant. We recognize the tragedy of Keith's death and we are hoping to take this moment to raise awareness about organ donation." Keith had not listed himself as an organ donor on his license. "It is never easy when a family or our community confronts such heartbreak as this terrible accident. It would have been possible, however, for good to have come from Keith's organs. There is a tremendous shortage. Donating your organs is the ultimate gift-the gift of life for desperately ill people." This emotional plea sparked a fervent debate among parents. Many left wondering whether conversations like these had a place at school board meetings or in schools themselves. Many in the community turned to Dr. Gomez for his opinion. Did he believe in educating patients about organ donation? He could bring it up at yearly physicals, as he did with advance directives-why didn't he? Did he think it was an appropriate topic for a public forum? Commentary In the aftermath of a seemingly heated public debate about organ donation at a school board meeting, Dr. Gomez faces difficult questions related to physicians' moral obligations to promote the well-being of patients and society. This case raises three main questions. First, do family physicians have a moral responsibility to educate patients about organ donation? Second, should organ donation be discussed at yearly physicals, following the model of discussions about advance directives?