Dr. Wall and his team published an article discussing the potential for a 63% increase in donors, if the U.S. began to pursue uncontrolled donation after circulatory determination of death (UDCDD). As the majority of deaths occur unexpectedly and outside of the hospital environment and rarely become organ donors, following a two-step process for organ donation in unexpected deaths may increase the number of donors. The first step would involve asking the family for permission for organ preservation. This decision would not commit the family to donation, however, it would keep the option open for a later decision. The second step would be after the family has had time to process their loss, to ask the family for authorization for donation. Wall et al. suggest the term “unexpected” death versus an “uncontrolled” donation may be a more effective way of communicating with families and that the term “preservation” might be less of a commitment than an immediate request for donation in an unexpected death.
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