The barriers to organ and tissue donation in palliative care

Clinical review
First published in this online journal
Declaration of interests: 
Mary Spencer
Author profile (accurate when this article was originally published): 
Mary Spencer is Staff Nurse, Inpatient Unit, St Christopher’s Hospice, London. Email:

Discussions about organ/tissue donation are now expected to become part of end-of-life care discussions, when appropriate. It is commonly perceived that terminally ill people are not eligible to donate their organs/ tissues. However, that is not the case. Palliative care patients can donate various tissues, including corneal tissue, and in some cases organs. Donation rates from palliative care patients are low as a result of a variety of factors, e.g. the family not knowing the deceased’s wishes, negative attitudes to organ/tissue transplantation among relatives and clinicians, fears of disfiguring the body and wanting to protect the deceased person from further harm. Health professionals can be reluctant to broach the topic of tissue donation with patients and/ or their families/next of kin. This article will explore the involvement of palliative care patients in decisions about donating their tissues, why families may be reluctant to consent to donating organs/tissues of deceased loved ones and reasons why nurses are wary of discussing the possibility of donation with patients and/or their next of kin. Recommendations for practice will also be made.

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