Professions, families, and control in the management of the cadaver organ donor.

In times of medical crisis, control over the treatment process is vested with the patient's attending physician. The role of the other members of the treatment team is clearly supporting of the physician while the patient's family exercises little or no influence over the treatment process. In certain "rare" events, the traditional roles are suspended and control of the process is, at lest temporarily, shifted to an outside group of health professionals. The process of cadaver organ donor donation is presented as an example of the suspension of traditional role responsibilities and the delegation of control to an external agent. Through direct observation of role interaction, in-depth interviews with medical personnel and a survey of critical care nurses, this process of shift in control is examined. Although the issues of time and the locus of control serve to constrain this process, the decision to accept or decline the request for organ donation ultimately lies with the patient's family. Under these rare circumstances, the family is asked to suspend their beliefs regarding life and death in favor of a new set of norms introduced by this external agent.