Exploring the dilemma of hospital refusal to perform controlled organ donation after circulatory death (DCD)

Organ donation following circulatory death (DCD) or brain death (BD) facilitates life-saving transplantation for thousands of patients worldwide each year. Both DCD and BD protocols require that the donor be declared dead before organ procurement. Some hospitals refuse to perform DCD donations based on moral and other objections, and this creates a complex dilemma for families attempting to honor the donation wishes of their relatives. Because organ donation is a community good, any accommodation of staff objection that impedes or harmfully delays DCD donation is ethically impermissible. Furthermore, hospital refusal to perform DCD donation is ethically untenable.