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October 14, 1992

Diagnosis of Brain Death and Organ Donation-Reply

Author Affiliations

American Medical Association Chicago, Ill

JAMA. 1992;268(14):1859-1860. doi:10.1001/jama.1992.03490140067033

In Reply.  —As Dr Surman observes, the scarcity of cadaveric organs is a serious problem. Physicians should redouble their efforts to educate the public about organ donation and to encourage more people to volunteer their organs for transplantation.However, there is good reason to separate discussions about withholding or withdrawing life-sustaining treatment from discussions about organ donation. When the two issues are considered together, patients may fear that the need for more organs is causing the medical profession to be less aggressive about treating seriously ill patients. Many people already believe that concerns about rising health care costs are causing health care providers to encourage greater use of living wills and other advance directives.1 If policies for organ donation are developed in the context of policies for the curtailment of life-sustaining treatment, the public might become more reluctant to volunteer as organ donors.Surman notes that organ donation may