Our duty of care

Every effort will be made to save your life above all else

Doctors and nurses manage the care of a patient and are committed to doing everything possible to save a person’s life.
  
Only when they’ve agreed and discussed with your family that nothing more can be done, a sensitive discussion will start to take place about the possibility of donation. 

Only when end-of-life care planning is started, or in some cases after a patient has died, is the NHS Organ Donor Register is accessed by specialist nurses and the possibility of organ or tissue donation discussed with family or friends

Death is confirmed in line with strict criteria

There are strict criteria in place in Scotland to help those caring for the dying, by providing safe, timely and consistent criteria for the diagnosis of death. Organs or tissue are never removed until a patient’s death has been confirmed in line with these criteria.
  
Death is confirmed by doctors who are entirely independent of the transplant team and this is done in the same way for people who donate organs as for those who do not. If organ or tissue donation is a possibility, specialist nurses will check to see whether an individual is on the NHS Organ Donor Register, and the family of a potential donor will always be consulted to check if the person had expressed any views about donation.

How is death confirmed in Scotland

In order for a person to become an organ donor, doctors must first decide if the heart is no longer beating (circulatory death) or if the brain is no longer working (brainstem death; also referred to as death determined by neurological criteria). Doctors will confirm the death of a patient as either circulatory or brainstem death before donation can take place.

Donation after circulatory death

Organ and tissue donors who donate after death has been confirmed by circulatory criteria will often have been treated in a hospital, but their injuries will be such that death is inevitable. Any medical interventions (such as a ventilator) which are prolonging the dying process will be removed. Only after the patient’s heart has stopped beating for five minutes can death be confirmed.  Donation then takes place after death is confirmed. 

Donation after brainstem death

People who become donors after death has been confirmed by neurological criteria will usually have died in a way that leaves them with a brain injury from which they are not able to recover. They will be unable to regain consciousness and unable to breathe for themselves. They are typically on a ventilator in hospital.

For more information about brainstem death, please visit NHS Inform. 

Common misconceptions

Organ and tissue donation will hurt
Organ and tissue donation takes place after someone has died, so it can't hurt. In some cases you can however choose to donate an organ such as a kidney, while you are still alive – but this would be done under general anaesthetic. More about living kidney donation.

Organ and tissue donation will leave my body disfigured
Organs and tissue are always removed with the greatest care and respect. Organ donation takes place in a normal operating theatre and is carried out by specialist healthcare professionals, who make sure the donor is treated with dignity. Tissue donation normally takes place in facilities in a mortuary.  Arrangements for viewing the body after donation are the same as after any death.