When organ donation is considered for a brain‑dead patient without an advance directive, which is the correct initial action?

• A. Obtain consent from the closest family member
• B. Delay decision until a court orders action
• C. Proceed with organ donation without consent
• D. Consult the patient’s attorney for approval

Answer: (A)

When there is no advance directive, the first step in organ donation is to obtain consent from the closest family member or legally authorized surrogate. After brain death is determined, the organ procurement organization works with the family to discuss donation, answer questions, and secure permission before any donation proceeds. This approach respects the patient’s and family’s wishes and follows legal and ethical standards.

Delaying the decision for a court order isn’t required, and proceeding without consent isn’t appropriate. Consulting the patient’s attorney isn’t the typical initial action in the donation process; the focus is on informing and obtaining family consent through the appropriate channels.