Cullip Mackenzie, Sarti Aimee J, Weiss Matthew J, Whittingham Heather, Meade Maureen O
Acad Forensic Pathol. 2022 Jun;12(2):65-74. doi: 10.1177/19253621221106892. Epub 2022 Jun 29.
Death investigators (DIs) such as coroners, medical examiners, and forensic pathologists play important and evolving roles in deceased organ donation. DIs communicate with organ donation organizations (ODOs) to gather case-specific information and release or restrict organs depending on the medicolegal requirements. This scoping review aims to identify the breadth of roles and decision-making processes that may facilitate or hinder deceased donation in DI cases.
This study was conducted using a scoping literature review and subsequent thematic analysis.
Thirty-one eligible papers described 8 common themes with region-specific nuances. These include: 1) shared (ODO and DI) protocols for early communication around each case; 2) shared standards and education for death investigation practices related to organ donation; 3) DI support staff or teams to facilitate organ donation; 4) DI authority to order additional testing and imaging before organ recovery; 5) donation-specific legislation to enhance DI and/or ODO operations; 6) legally trained DI authority to veto medical decisions to proceed with organ donation; 7) DI attendance at organ recovery; and 8) surgeons recording specific DI evidence during organ recovery.
These findings have cultural and resource-allocation implications and expose gaps in the international literature describing practices at the intersection of deceased organ donation and death investigation. A better understanding of the rationale and execution of various systems for DI and ODO cooperation may serve to advance both organ donation and death investigation.
死因调查人员，如验尸官、法医和法医病理学家，在死者器官捐赠中发挥着重要且不断演变的作用。死因调查人员与器官捐赠组织（ODO）沟通，以收集特定病例的信息，并根据法医学要求决定是否释放或限制器官。本范围综述旨在确定在死因调查人员处理的案件中，可能促进或阻碍死者器官捐赠的角色范围和决策过程。
本研究采用范围文献综述及后续主题分析的方法进行。
31篇符合条件的论文描述了8个具有地区特色细微差别的共同主题。这些主题包括：1）针对每个病例进行早期沟通的共享（ODO和死因调查人员）协议；2）与器官捐赠相关的死因调查实践的共享标准和教育；3）协助器官捐赠的死因调查人员支持人员或团队；4）死因调查人员在器官获取前下令进行额外检测和成像的权力；5）加强死因调查人员和/或ODO运作的特定捐赠立法；6）经过法律培训的死因调查人员有权否决进行器官捐赠的医疗决定；7）死因调查人员出席器官获取过程；8）外科医生在器官获取过程中记录特定的死因调查证据。
这些发现具有文化和资源分配方面的影响，并揭示了国际文献中在描述死者器官捐赠和死因调查交叉领域实践方面的空白。更好地理解死因调查人员和ODO合作的各种系统的基本原理和执行情况，可能有助于推动器官捐赠和死因调查的发展。
