The growth of organ transplantation has led to increased physician assistant involvement in the organ procurement process. Consent for organ donation must be obtained from the family of the brain-dead patient prior to discontinuation of life-support systems. This is a complex and difficult task for the counseling clinician. It requires a sound understanding of brain death, the mechanics of the procurement system, and the needs of the donor family. In this article, a specialist offers practical guidelines to PAs who wish to help these families make informed decisions about organ donation.