Does organ donation impact on forensic outcomes? A review of coronial outcomes and criminal trial proceedings

Despite increases in organ donation rates, there continue to be waiting lists for patients in urgent need of transplantation. Where a death occurs under a number of specific circumstances, donation can only proceed where a coroner consents to donation. In deaths that are reportable under the Coroners Act, concerns about compromising autopsy evidence can be barriers to gaining coronial consent for retrieval. Objectives: This study aimed to identify the impact of organ donation, where it did occur, on coronial processes and on trial proceedings where a criminal trial ensued. Where donation was restricted by the coroner or forensic pathologist we sought to determine whether it would have affected forensic determinations. Design: We retrospectively examined 177 records of reportable deaths referred for organ donation over a four year period in Queensland Australia. We also reviewed records of any criminal proceedings which were commenced in relation to these deaths. Results: There were 10 cases in which the forensic pathologist recommended restrictions to organ donation with the loss of a number of organs to transplantation. There was no case where organ donation altered the outcome of criminal proceedings or significantly impacted cause of death findings. Conclusions: Organ donation, where permitted, had limited impact on autopsy evidence and any subsequent court proceedings. Where organ donation was not permitted, autopsy evidence did not significantly alter coronial findings or judicial outcomes.