Personalised organ donation directives (PODDs) offer a potential solution to the problem of the family veto.
The adoption of personalized organ donation directives (PODDs), as described in the editorial by Shaw [ 1] in a previous issue of Critical Care, offers a potential solution to the problem of family veto and may prevent the need to convince the family to donate at the time of bereavement.
They refused consent for donation, since their deceased had not given any directive.
Among the 49 surrogate decision makers consulted for consent, 15 (31%) denied permission for organ donation: 3 transmitted the dead person advanced directives, while 12 refused it in the absence of or contrary to the donor's directives.
Non donor families feel incompetence to decide and refused donation, whilst their deceased had not given any directive.
When forced to make a surrogate decision, some non-donor families refused consent for donation, because their deceased had not given any directive.
The directive must state, quite unequivocally, that the donation of tissue or cells can only be done out of the donor's free will and always without payment, except possibly for compensation to reimburse travel expenses or light refreshments.
The legal framework for tissue donation, banking and usage in the EU is comprised of three EC Directives: the parent Directive 2004/23/EC, which provides the framework legislation, and two technical Directives, 2006/17/EC and 2006/86/EC, which give detailed requirements.
Any wishes expressed explicitly by an adult patient (donor card, which can be likened to an advance directive for multiorgan retrieval; and verification of the donation refusal registry) should be honored.
In Italy, differently from other European countries, the only possibility of advance directive is the one made by the organ donation.
