I got an email asking about this, so here is my take:
Whenever a person is about to die, let’s say that they are brain dead but on life support, the hospital will evaluate the patient’s record to see if they are an organ donor. Whether they are or not, the organ donation people will be contacted. That organization will then determine if the person is a candidate for donating organs (not everyone is medically capable of donating their organs.)
If the person has previously agreed to be an organ donor, the person will immediately be screened to see if they are a match for anyone on the recipient list. The transplant team in the recipient’s hospital will be contacted, and they hop on a plane to harvest the organ.
If the person hasn’t indicated either way, the organization will contact the next of kin and attempt to gain consent for organ donation.
No one is taking anyone’s organs without consent. All the organization is doing is acting as a coordinator for the process. If you don’t want to be an organ donor, make sure that you indicate your wishes in your will or living will and make sure that your next of kin is aware of your desires. It’s up to you.
With that being said: No, the hospital doesn’t change your care if you are or are not an organ donor, other than keeping a person that is brain dead on life support a bit longer before “pulling the plug” so as to preserve some of the more sensitive organs like heart or liver. No, it isn’t like signing a DNR.
They aren’t less likely to try and save you for increased profits or anything like that. Chances are, the recipient of your donated organ is hundreds of miles away in another state. As an ED nurse, I work a lot of codes. I do not know, nor do I care, what your organ donation status is before I call your code.
The only thing this is for is to save lives by giving people with defective organs a shot.
A great example of this: A guy comes into the ED by EMS and is brain dead due to some sort of accident. He isn’t savable, his brain is gone, but he is otherwise young and healthy. Why leave his organs to rot when so many people need donations? So the organ donation people get a call, and those people review the record to see if he is an organ donor. If he isn’t, they will try to gain consent of the next of kin. Either way, once they gain consent, they will send out the notifications to the appropriate recipient teams.
Nothing nefarious. It’s all consensual, and it doesn’t change the potential donor’s care one whit.