We share Dr Friedman's advocacy of organ and tissue donation. We are cognizant of the aegis of statutory tort under which we serve, including the Uniform Determination of Death Act1 and the Omnibus Reconciliation Act of 1986.2
Theoretically and teleologically (ends, products, and results), discussions regarding organ and tissue donation and other advanced directives would begin early in a patient-physician encounter. In elective and outpatient settings, those topics would be less emotionally charged, and appropriate information could be provided to assist patients with deliberative informed decisions. Pragmatically and deontologically (means and processes), in the context of the scenario that we provided, it is problematic because of the emotionally intense atmosphere and the potential for allegations of a conflict of interest. Indeed, organ and tissue donation might be unfeasible in such settings if postmortem analysis were deemed essential from medical/legal perspectives.