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Grief support for families, organ transplants

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In Chapter 2 of Brain Dead Person I stressed that the first thing the medical staff in the ICU should do in terms of ethics when brain death is diagnosed is to care for the family members who are attending the brain dead patient. In 1989, there was very few literature that dealt with psychological care for the family in trems of bioethics.

I have read Ann Mongoven's paper, "Giving in Grief: Perspectives of Hospital Chaplains on Organ Donation" (in Caring Well, ed.by D.H.Smith, 2000) and found it very interesting because she approaches the same topic from a different angle.

She interviewed hospital chaplains who had experience of approaching the family of a brain dead patient. She found that the goal of the chaplains was not necessarily to acquire organs. Their ultimate goal was to provide the family with grief support. "All of the chaplains interviewed located their perceived role in organ donation within a broader context of grief support" (p.174). What I proposed in the book, Brain Dead Person Ch.2 was also a kind of grief support, and I went on to stress that this grief support and the family's acceptance of the death of the patient should be a necessary condition of organ transplants from a brain dead patient. Mongoven didn't say the latter, but her paper succeeded in fully illustrating the various aspects of chaplains' approaches. "They emphasized the need for "time", questions of "timing", and "sensitivity to the process" in their comments......... Repeatedly mentioned "big little things" included a quiet, private place for the family, moments when they were left alone....." (p.178).

The concept, "quiet, private place and moments" was emphasized in Brain Dead Person too, and welcomed by professionals at that time. I was moved to see the same phrase appear in the chaplains' words in the US.

(To be continued..)

Photo: Kadomatsu: New Year ornament

 -- M.Morioka www.lifestudies.org

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