Organ donation occurs as a culmination of 2 processes: the ending of a patient’s life and the gaining of permission for donation from the patient or the patient’s family. Donation cannot occur outside these contexts, and thus understanding end-of-life issues and having a commitment to a caring request process are essential. Nurses are the caregivers most intimately involved in end-of-life care and so have the capacity to greatly affect requests for organ donation. Without appropriate, skilled end-of-life care and skilled, knowledgeable communication with patients’ families, donation (and the opportunity to help recipients) will not occur. Nurses share responsibility with other healthcare providers for the quality of both end-of-life care and the conditions that may affect the donation process.

In this article, I set the stage for other articles in this issue of Critical Care Nurse by briefly summarizing current norms regarding end-of-life care and persistent areas of concern. I also...

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