The impact of organ donation on coronial processes and forensic investigation: A literature review

Abstract

There are competing requirements between organ donation for transplantation and coronial/forensic investigation. Both require access to the body of the deceased. Optimally preserving physical evidence may reduce availability of organs for life saving transplants. Performing organ retrieval could impact on death determination and at worst could potentially interfere with criminal trial outcomes.

Objective: To summarise published literature regarding the interaction between organ donation and coronial/forensic processes.

Methods: A standard search strategy using the terms organ donation and coroner or medical examiner.

Results: There is a paucity of published literature. The incidence of coronial restriction of donation varies between jurisdictions and between individual practitioners. A significant number of organs are lost to transplantation through coronial restrictions. A number of strategies have been proposed to reduce the rate of coronial restrictions but implementation is inconsistent despite support from forensic professional bodies. There was no published report of a significant impact on death determination or trial outcome caused by organ retrieval.

Conclusions: Increased consistency in coronial/forensic decision making and implementation of recognised strategies would increase the availability of organs for transplantation.

Keywords: Coroners and medical examiners; Forensic medicine; Organ donation; Organ procurement.