Increasing awareness of tissue donation: in the non-heart beating donor

Many healthcare professionals (nursing and medical staff) are familiar with asking families to consider organ donation in the brain-stem death patient. In contrast few healthcare professionals raise the subject of tissue donation with the newly bereaved non-heart beating donor (NHBD) families following cardiac death. The failure of healthcare professionals to approach theses families is strongly supported in the literature [Crit. Care Nurs. Clin. N. Am. 4 (1992) 63; William and Calif, 1996; Prof. Nurse 12 (1997) 482]. Coyle [Intensive Crit. Care Nurs. 16 (2000) 45] identified that for many nurses the conflict arises from the ethical principle of beneficence to do good and non-maleficence to do no harm. However, why is requesting organ and/or tissue donation an ethical issue, should it not be part and parcel of the care offered to bereaved families? Are healthcare professionals not making an issue of it? This article critically analyses the issues surrounding tissue donation and the role of healthcare professionals in raising awareness of eligibility for tissue donation. A tool of structured reflection [J. Nurse Manager 1 (1993) 9] will be used to highlight the use of reflective practice following a critical incident. On the basis of analysis of current practice consideration will be given for future theoretical arguments in development, research, and education.