Dual Advocates in Deceased Organ Donation: Appreciating Moral Distress in OPO Staff
Saturday, October 14, 2023
1:15 PM – 2:30 PM ET
Location: Bristol (Third Floor)
Organ procurement organization (OPO) staff play an essential role in the facilitation of organ donation as they walk dying patients’ families and loved ones through the donation process. Throughout this process, OPO staff must assume the role of a dual advocate, considering both the interests of the donor, which often include the wishes of the donor’s family, and the interests of potential recipient(s). The benefits of this role are well-established; however, minimal literature currently exists on the ways that this role can cause moral distress in OPO staff, who frequently face scenarios where adhering to the wishes of a donor family may compromise donation potential but failing to conform to their requests may result in further emotional burden for the family. In this paper, we examine three such circumstances: (1) donor families objecting transfer to an alternative hospital for organ recovery, (2) donor families insisting that the donation process occur within a specific timeframe, and (3) donor families declining brain death testing in lieu of donation after circulatory death in order to be present when the patient’s heart stops. Given they routinely navigate ethically complex situations like these, OPO staff are at heightened risk for experiencing moral distress and burnout. Despite this, OPO staff are seldom acknowledged in the existing moral distress literature and, as a result, it is not clear that the current practices in place for mitigating moral distress are beneficial for this population.
Hannah Boylan, MA – Family Services Coordinator, Clinical Department, LifeCenter Organ Donor Network