The Perspective doesn’t address specific circumstances of a patient asking to donate before death, other than demonstrating sound judgment. “Clinicians must confirm that patients have decisional capacity and that their choices are fully informed, voluntary, and not unduly influenced by treatable or reversible conditions, such as some forms of mental illness,” Ian Ball, MD, from Western University, Robert Sibbald, MSc, from the London Health Sciences Center, both in Ontario and Robert Truog, MD, from the Center for Bioethics at Harvard Medical School write.

So who could donate before death?

I’ve had cancer twice, so my organs are off limits, as would be those of people harboring serious infections. That leaves accident victims with sufficient brain function to make rational decisions, and perhaps people with terminal neurological conditions that don’t impair cognition or damage organs. It’s difficult to even think about.