A retrospective evaluation of informed consent for tissue donation within a year of the donor's death

By German law organ and tissue donation may only be done if explicit consent is given during lifetime, e.g. by a donor card, or if the family grants informed consent after death in line with the deceased's last will, what is discussed to mean an additional emotional load in the situation of mourning.Every year about 35 musculoskeletal tissue donations and 250 donations of corneoscleral discs (means 125 donors) are performed in the Hamburg Institute of Legal Medicine. Talking to the next of kin plays a key role in the consenting process for donation. We show our guidelines according to the family contact by telephone and present the results of a catamnestic review referring to the donors of one year's period. Methods: One year after procurement had been completed we requested the consenting person to answer a questionnaire and asked for an evaluation of the contact to the institute's coordinator and furthermore the emotional impact of the consenting process. Results: 26 (72.2% of 36 only musculoskeletal donors) and 77 (73.3% of 114 only cornea donors) consenting persons answered and gave a positive feedback in the dimensions of information, support and consent. Discussion: The telephone contact with families of deceased persons out of the Institute of Legal Medicine is perceived to be helpful in an acute stress situation caused by a sudden death and an accepted way to establish the deceaseds’ wishes in respect to donation through the relatives. Conclusion: According to the letter of the German Transplantation Act asking for donation is an obligation for every physician and our data show that this means no additional burden for relatives, if the question is placed appropriately. Forensic institutes play a key role in the recognition of tissue donors and take up the challenge to act as an interface between donors and recipients. But caring for the sufficient supply with tissue transplants needs considerable resources. Therefore additional support is necessary to fulfill this task.