The recent publication appeared in Intensive Care Medicine of the article “Intensive care admission aiming at organ donation”1 reminds us of the need to address the organ donation process at the intensive care units (ICUs) setting with particular care. In the text, the authors highlight the moral uncertainties and insecurities surrounding the entire organ donation process, which prevent definitively closing the ethical debate on the issue of ICU admission solely to facilitate organ donation.

The article suggests considering 2 fundamental aspects. Firstly, what the authors call “holistic care”: the fact that when a patient becomes a donor, they transition from being a subject to an object, with the danger of instrumentalizing the person and reducing them to a mere means for another person's end. Secondly, the authors emphasize the centrality of patient- and family-centered care. The patient should die with dignity, and the family expects them to be treated as a person in full sense, and not as mere organ suppliers.

The authors conclude with 3 recommendations. Firstly, the need for a broad public debate focused on transparency and dialogue in the process. Secondly, the need to consider the emotional and moral cost that the ethical uncertainty inherent in this process creates for ICU professionals. Thirdly, always considering the circumstances, needs, and wishes of both the patient and their family.

This reflection is particularly relevant for Spanish intensivists given the importance and social significance of organ donation in Spain,2 the essential role of ICUs in this process,3 and the emphasis on professional training.4 Hence, it is crucial for the health care personnel involved to be aware, in each case and at all times, of the risks of reducing the patient's integrity as a person, as well as taking the necessary precautions to safeguard them in such processes. Moral difficulties are inherent in any organ donation scenario and cannot be reduced to other legal, scientific, or social utility issues.

This requires professionals a practical and prudent knowledge, based on an awareness of the profound moral depth of the subject, as well as the multiple circumstances and complexities surrounding each patient, a unique and irreplaceable personality also present in the donation process.5