Brain Death

Authority	Manx Care
Date received	2026-01-26
Outcome	Some information sent but part exempt
Outcome date	2026-02-20
Case ID	5253493

Summary

The requester asked Manx Care for detailed protocols on brain death determination, organ donation statistics since 2011, and clinical procedures for organ retrieval. Manx Care responded that specific clinical guidance is already publicly accessible via an NHS link and provided a form regarding patient care, citing Section 20 of the Act to withhold the detailed information requested.

Key Facts

Manx Care determined that the requested information on brain death diagnosis and clinical management is already reasonably accessible to the public.
The authority directed the requester to the NHS Organ Donation and Transplantation website for best practice guidance on donation after brainstem death.
A document titled 'Frm7261' was attached to the response to explain the care of patients after death.
The response was issued on 16 February 2026 regarding a request received on 26 January 2026.
The authority invoked Section 20 of the Freedom of Information Act to avoid providing information that is already available.

Data Disclosed

26 January 2026
16 February 2026
11th October 2011
Section 20
Frm7261
https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after-brainstem-death/

Exemptions Cited

Section 20 of the Act (Information already reasonably accessible)

Original Request

1. Please can you confirm how Manx Care determines if a patient is brain dead in order that their organ's can be procured, what specific tests are undertaken and which ones are legally required to rule a patient brain dead.2. Please can you show any changes there have been to this definition of brain death from 11th October 2011?3. Please can you confirm how many Isle of Man based patients have been declared brain dead become organ donors from 11th October 2011, year by year.4. Please can you confirm if Isle of Man based patients that are organ donors have their organs removed here on island or if not where the patient is taken for the organ removal procedure?5. If removal is performed on Island please can you confirm:-5a. What drugs would typically be administered to a brain dead patient before and during the procedure?5b. Specifically are any sedatives ever used or are routinely used during the procedure?5c. Is an anaesthetist present at the beginning of the procedure?5d. Is an anaesthetist present during the procedure?5e. Is an anaesthetist present at the end of the procedure? At what point do they typically leave?6. Please can you confirm briefly explain the potential effects of 10 minutes of no oxygen / breathing to the human body?7. Please can you confirm the Organs which would typically be removed from a 25 year old donor, how this would occur and in what order would the Organs / body parts be removed and would the heart / blood / respiratory system and circulatory systems be kept artificially pumping during this procedure? Would the heart be kept pumping would it be one of the last things to be taken?8. Please can you confirm what organs have been donated by Isle of Man based patients from 11th October 2011, year by year.9. Please can you confirm what organs have been received via organ donations by Isle of Man based patients from 11th October 2011, year by year.10. Would the time of death be certified before or after the organ donation retrieval process by the doctor?11. If a patient is not an organ donor then what happens if the family decide to remove a brain dead patient from a ventilator?12. Are patients who are considered brain dead and ventilated given nutrients / tube feeding?13. Are patients that are considered brain dead on a ventilator administered sedative drugs?Thank you Thank you

Data Tables (1)

Full Response Text

Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000

Our ref: 5253493 16 February 2026

Dear ###

We write further to your request, received 26 January 2026, which states:

"1. Please can you confirm how Manx Care determines if a patient is brain dead in order that their organs can be procured, what specific tests are undertaken and which ones are legally required to rule a patient brain dead. 2. Please can you show any changes there have been to this definition of brain death from 11th October 2011? 3. Please can you confirm how many Isle of Man based patients have been declared brain dead become organ donors from 11th October 2011, year by year. 4. Please can you confirm if Isle of Man based patients that are organ donors have their organs removed here on island or if not where the patient is taken for the organ removal procedure? 5. If removal is performed on Island please can you confirm: -5a. What drugs would typically be administered to a brain dead patient before and during the procedure? 5b. Specifically are any sedatives ever used or are routinely used during the procedure? 5c. Is an anaesthetist present at the beginning of the procedure?5d. Is an anaesthetist present during the procedure? 5e. Is an anaesthetist present at the end of the procedure? At what point do they typically leave? 6. Please can you confirm briefly explain the potential effects of 10 minutes of no oxygen / breathing to the human body? 7. Please can you confirm the Organs which would typically be removed from a 25 year old donor, how this would occur and in what order would the Organs / body parts be removed and would the heart / blood / respiratory system and circulatory systems be kept artificially pumping during this procedure? Would the heart be kept pumping would it be one of the last things to be taken? 8. Please can you confirm what organs have been donated by Isle of Man based patients from 11th October 2011, year by year. 9. Please can you confirm what organs have been received via organ donations by Isle of Man based patients from 11th October 2011, year by year. 10. Would the time of death be certified before or after the organ donation retrieval process by the doctor? 11. If a patient is not an organ donor then what happens if the family decide to remove a brain dead patient from a ventilator? 12. Are patients who are considered brain dead and ventilated given nutrients / tube feeding?

Are patients that are considered brain dead on a ventilator administered sedative drugs?

Thank you"

Response

The detailed information you are seeking on diagnosis and clinical management of patient who have died by neurological criteria (commonly referred to as brain dead) can best be found via this web link: https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after- brainstem-death/ A copy of the Frm7261 is attached which explains the care of the patient after death by neurological criteria.
1. Please can you confirm how Manx Care determines if a patient is brain dead in order that their organs can be procured, what specific tests are undertaken and which ones are legally required to rule a patient brain dead.

The clinical process of donation is the same in the Isle of Man as in the UK. Therefore, under section 20 of the Act, we are not required to provide information in response to a request if it is already reasonably accessible to you, whether free of charge or on payment of a fee. Information can be found by accessing this website: https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after- brainstem-death/

Please can you show any changes there have been to this definition of brain death from 11th October 2011?

The clinical process of donation is the same in the Isle of Man as in the UK. Under section 20 of the Act, we are not obliged to provide this information that can be found elsewhere. https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after- brainstem-death/

Please can you confirm how many Isle of Man based patients have been declared brain dead become organ donors from 11th October 2011, year by year.

The clinical process of donation is the same in the Isle of Man as in the UK. Under section 20 of the Act, we do not need to provide information that can be found

elsewhere. The Isle of Man is part of the region covered by the North West Organ Donation Services Team; https://www.odt.nhs.uk/statistics-and-reports/regional-reports/

Please can you confirm if Isle of Man based patients that are organ donors have their organs removed here on island or if not where the patient is taken for the organ removal procedure?

Organ donation happens in the Isle of Man with a visiting specialist nurse and a visiting surgical team. Patient are not transferred to the UK for the purpose of organ donation, though there have been occasions when a seriously ill or injured patient was transferred to the UK, they subsequently died and donated their organs.

The visiting specialist nurse and surgical team guide the care of the patient, before, during and after donation has taken place. They request the staff needed from the local hospital. As such, the clinical process of donation is the same in the Isle of Man as in the UK.

If removal is performed on Island please can you confirm: 5a. What drugs would typically be administered to a brain dead patient before and during the procedure? 5b. Specifically are any sedatives ever used or are routinely used during the procedure? 5c. Is an anaesthetist present at the beginning of the procedure? 5d. Is an anaesthetist present during the procedure? 5e. Is an anaesthetist present at the end of the procedure? At what point do they typically leave?

While our aim is to provide information whenever possible, under section 20 of the Act, we are not required to provide information in response to a request if it is already reasonably accessible to you, whether free of charge or on payment of a fee. Please see below website for information. https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after- brainstem-death/

Please can you confirm briefly explain the potential effects of 10 minutes of no oxygen / breathing to the human body?

While our aim is to provide information whenever possible, under section 20 of the Act, we are not required to provide information in response to a request if it is already reasonably accessible to you, whether free of charge or on payment of a fee.
https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after- brainstem-death/

Please can you confirm the Organs which would typically be removed from a 25 year old donor, how this would occur and in what order would the Organs / body parts be removed and would the heart / blood / respiratory system and

circulatory systems be kept artificially pumping during this procedure? Would the heart be kept pumping would it be one of the last things to be taken?

Please can you confirm what organs have been donated by Isle of Man based patients from 11th October 2011, year by year.

Please can you confirm what organs have been received via organ donations by Isle of Man based patients from 11th October 2011, year by year.

Would the time of death be certified before or after the organ donation retrieval process by the doctor?

If a patient is not an organ donor then what happens if the family decide to remove a brain dead patient from a ventilator?

https://www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after- brainstem-death/

Are patients who are considered brain dead and ventilated given nutrients / tube feeding?

Are patients that are considered brain dead on a ventilator administered sedative drugs?

If you have questions about a particular close family-member and are suffering distress as a result of lingering uncertainty around the process of organ donation, I suggest you get in touch with the clinicians who cared for your family member. They may be able to help you understand what happened. MCALS is a good first point of contact for these enquiries.

Please quote the reference number 5253493 in any future communications.

Your right to request a review

If you are unhappy with this response to your freedom of information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post.

An electronic version of our complaint form can be found by going to our website at https://services.gov.im/freedom-of-information/Review . If you would like a paper version of our complaint form to be sent to you by post, please contact me and I will be happy to arrange for this. Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If you are not satisfied with the result of the review, you then have the right to appeal to the Information Commissioner for a decision on;

Whether we have responded to your request for information in accordance with Part 2 of the Freedom of Information Act 2015; or
Whether we are justified in refusing to give you the information requested.
In response to an application for review, the Information Commissioner may, at any time, attempt to resolve a matter by negotiation, conciliation, mediation or another form of alternative dispute resolution and will have regard to any outcome of this in making any subsequent decision. More detailed information on your right to a review can be found on the Information Commissioner’s website at www.inforights.im. Should you have any queries concerning this letter, please do not hesitate to contact me. Further information about freedom of information requests can be found at www.gov.im/foi.

I will now close your request as of this date.

Isle of Man FOI Wiki — 5,481 Freedom of Information requests, 2017–2026