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To the Editor Dr Wall and colleagues1 stated that UDCDD “requires initiation of organ preservation soon after death.” The authors suggested a permission process for initiating such preservation (step 1) and an authorization process for donation (step 2). I see 2 problems with this approach.
First, for adults who have already provided first-person authorization to be organ donors, there should be no need for an extra layer of permission by relatives to begin preservation and facilitation of donation in these deceased individuals. Families who refuse permission would be denying registered donors their donation wish—something that first-person authorization aims to protect.2
Bramstedt KA. Organ Donation After Circulatory Death. JAMA. 2015;314(15):1646. doi:10.1001/jama.2015.11414