“Haukeland Hospital Implements Controversial Organ Donation Method”

As the last hospital in the country, Haukeland is now also using a long-controversial method for organ donation.

The so-called cDCD method has met with opposition in several hospitals in Norway. For years, doctors and lawyers have debated whether it is safe to use it.

Reason: The method changes the criteria for when someone is declared dead in Norwegian hospitals.

Among other things, a balloon is used to stop the blood supply to the heart and brain.

Variants of the new method for organ donation are in use in several European countries, and Norway decided in 2021 to follow suit.

But one hospital refused to introduce it: Haukeland Hospital in Bergen.

Right up until now.

Made people unsubscribe as donors

The new method means that more organs can be saved and donated to patients, because the method allows doctors to declare death in several ways.

This means that more people can qualify to be an organ donor. According to Stiftelsen Organdonasjon, donor rates in Norway can increase by 10 to 20 per cent.

Several donors were a key argument for the decision-making forum opening up the use of the method.

Marta Ebbing, professional director at Haukeland, now confirms that Haukeland is also following.

Haukeland has spent a year and a half deciding to adopt the method.

On 2 May they decided to also say yes to the method.

In several articles, NRK has discussed the major debate surrounding the cDCD method.

After it became known to the public, a record number deleted their donor card after the method of organ donation was given the green light, according to Helsenett.

– There are still some who find it difficult

– We have not had an agreement on the method in our professional environment, says director of the department at Haukeland, Marta Ebbing

Some doctors have been concerned that the method could force the decision to withdraw life-prolonging treatment from intensive care patients, in order to gain access to organs.

They have also been concerned that the method could lead to a development in which the line between life and death for potential donors was moved.

– Our professionals wanted to discuss this thoroughly, says Ebbing

– Is there now a collective professional environment behind the decision?

– There are probably still some who will think it is difficult, says Ebbing.

She says the hospital will establish good routines that ensure both health personnel and relatives of the dying person who will eventually become a donor.

Among the arguments for introducing the method has been that Haukeland could have a reputational problem as the only donor hospital that does not use the method.

– We are also happy to be able to contribute to better access to organs, to give those who need it a better and longer life, says Ebbing.

Was used without approval

Previously, NRK revealed that the method was used on patients for several years, without it being approved by the health authorities. It happened after doctors traveled around the country and told them that the method was approved, which was not true.

Resistance was strong in several hospitals. The fear among doctors and lawyers has been that, in the worst case, patients could be declared dead in violation of the law and medical ethics.

This is the cDCD method

The method’s name cDCD is translated in Norwegian to donation after circulatory death and has received the thumbs up from the subject experts.

It can be explained briefly as follows:

• In Norway, death was previously defined by law as “total destruction of the brain”. Since 1977, the rule has been that death must be documented with an X-ray of the brain, before the organs can be removed.
• With the new method, the ventilator is disconnected, so that the patient dies of cardiac arrest.
• When the heart has stopped for five minutes, the patient is declared dead, without any examination of the brain. Then the doctors take out the organs.
• The debate in Norway has led to the introduction of several neurological tests in the procedure, such as testing the eye reflex. Now it must be absolutely certain that the patient is dead and cannot come back.