scholarly journals Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe

2021 ◽  
pp. 100673
Author(s):  
Alberto Molina-Pérez ◽  
Janet Delgado ◽  
Michaela Frunza ◽  
Myfanwy Morgan ◽  
Gurch Randhawa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Organ Donation ◽  
Organ Procurement ◽  
Public Knowledge ◽  
Knowledge And Attitudes ◽  
The Family ◽  
Deceased Organ Donation

scholarly journals Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe

2021 ◽  
Author(s):  
Alberto Molina Pérez ◽  
Janet Delgado ◽  
Mihaela Frunza ◽  
Myfanwy Morgan ◽  
Gurch Randhawa ◽  
...  
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Organ Procurement ◽  
Public Knowledge ◽  
The Public ◽  
Organ Retrieval ◽  
Knowledge And Attitudes ◽  
The Family ◽  
Deceased Organ Donation

Goal: To assess public knowledge and attitudes towards the role of the family in deceased organ donation in Europe. Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science. These databases were last searched on December 15th, 2017. Eligibility criteria were empirical studies conducted in Europe from 2008 to 2017 and addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Each record was screened by two or more independent reviewers in three phases. Data collection from each report was performed by two or more independent reviewers. Results: Of the 1,482 results, 467 reports were assessed in full-text form, and 33 were included in this synthesis. Studies show that a majority of the public support the family′s involvement in organ retrieval decision-making and, in particular, their role as surrogate decision-maker when the deceased has expressed no preference. Conclusions: A common conceptual framework and validated well-designed questionnaires are needed to address the role of the family in future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation.

Adolescent classroom education on knowledge and attitudes about deceased organ donation: A systematic review

2013 ◽  
Vol 17 (2) ◽  
pp. 119-128 ◽  
Author(s):  
Alvin Ho-Ting Li ◽  
Amanda M. Rosenblum ◽  
Immaculate F. Nevis ◽  
Amit X. Garg
Keyword(s):  
Systematic Review ◽  
Organ Donation ◽  
Knowledge And Attitudes ◽  
Deceased Organ Donation ◽  
Classroom Education

scholarly journals Public knowledge and attitudes towards consent policies for organ donation in Europe. A systematic review

2019 ◽  
Vol 33 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Alberto Molina-Pérez ◽  
David Rodríguez-Arias ◽  
Janet Delgado-Rodríguez ◽  
Myfanwy Morgan ◽  
Mihaela Frunza ◽  
...  
Keyword(s):  
Systematic Review ◽  
Organ Donation ◽  
Public Knowledge ◽  
Knowledge And Attitudes

Family perspectives on organ and tissue donation for transplantation: A principlist analysis

2017 ◽  
Vol 25 (8) ◽  
pp. 1041-1050
Author(s):  
Marcelo José dos Santos ◽  
Lydia Feito
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Sao Paulo ◽  
Tissue Donation ◽  
São Paulo ◽  
Ethical Considerations ◽  
Donation Process ◽  
The Family ◽  
Organ Procurement Organizations ◽  
Family Interview

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.

scholarly journals Impact of Donation Physicians on Deceased Organ Donation: A Systematic Review

2021 ◽  
Author(s):  
Janet E. Squires ◽  
Laura D. Aloisio ◽  
Wilmer John Santos ◽  
Danielle Cho-Young ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Organ Donation ◽  
Interrupted Time Series ◽  
Deceased Donor ◽  
Organ Donors ◽  
Consent Rate ◽  
Team Members ◽  
Study Selection ◽  
Before And After ◽  
Deceased Organ Donation

Abstract Background: An emerging strategy to increase deceased organ donation is to use dedicated donation physicians to champion organ donation. We sought to conduct a systematic review of the effectiveness of donation physicians in improving organ donation outcomes.Methods: A systematic review was conducted following Cochrane principles. MEDLINE, Embase, and CINHAL databases were searched from inception to March 26, 2020. Quantitative studies examining the effects of donation physicians on all deceased organ donation outcomes were considered for inclusion. Review articles, editorials and opinion articles, and case studies were excluded. Study selection was completed independently by two team members; all discrepancies were resolved by consensus. Two team members independently extracted data from studies. Results: A total of 1,017 studies were screened, and 12 met inclusion criteria. Included studies were published between 1994 and 2019. Half used an interrupted time series design (n = 6; 50%), three (25%) were cohort studies, and three (25%) used a before-and-after study design. Outcomes (reported in greater than 50% of included articles) included consent/refusal rate (n = 8; 67%), number of potential donors (n = 7; 58%), and number of actual donors (n = 7; 58%). Across studies and design types, there was an increase in potential organ donors ranging from 8 to 143% (Mdn = 33%), an increase in actual organ donors from 15 to 113% (Mdn = 27%), an increase in donor consent rate from -3 to 258% (Mdn = 12%) and an increase in deceased donor transplants from 13 to 24% (Mdn = 19%) following the introduction of donation physicians.Conclusions: Donation physicians have the potential to significantly improve deceased organ donation. Further implementation and evaluation of donation physician programs is warranted. However, implementation should be undertaken with a clear plan for a methodologically rigorous evaluation of outcomes.

The ‘opt-out’ approach to deceased organ donation in England: A misconceived policy which may precipitate moral harm

2019 ◽  
Vol 14 (2) ◽  
pp. 63-69
Author(s):  
Tobias K Cantrell
Keyword(s):  
Organ Donation ◽  
Public Awareness ◽  
Recent Attempt ◽  
Individual Autonomy ◽  
Presumed Consent ◽  
Opt Out ◽  
The Family ◽  
Deceased Organ Donation ◽  
Tissue Act ◽  
Human Tissue Act

In an effort to solve the shortage of transplantable organs, there have been several proposals to introduce an opt-out approach to deceased organ donation in England (also termed ‘deemed’, or ‘presumed’ consent). In seeking to enact the so-called ‘opt-out proposal’ via an amendment to the Human Tissue Act 2004, The Organ Donation (Deemed Consent) Bill 2017–19 represents the most recent attempt at such legal reform. Despite popular calls to the contrary, I argue in this paper that it would be premature for England, or, indeed, any country, to adopt an opt-out approach at this time. Not only is the available evidence inconclusive on whether introduction of the opt-out proposal would increase the supply of transplantable organs (a common misconception), but there is also a chance that doing so might bring about an otherwise avoidable moral harm through an unjustified interference with individual autonomy. I maintain that the resources required to change the law to such effect would be better expended on alternative, provenly efficacious and less contentious mechanisms for increasing the supply of transplantable organs, such as: improving communication with the family of the deceased, developing infrastructure, raising public awareness and enhancing staff training, attitudes and understanding towards organ donation.

scholarly journals Exploring the experiences and perspectives of substitute decision-makers involved in decisions about deceased organ donation: a qualitative study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e034594 ◽  
Author(s):  
Jacob Crawshaw ◽  
Justin Presseau ◽  
Zack van Allen ◽  
Livia Pinheiro Carvalho ◽  
Kim Jordison ◽  
...  
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Self Regulation ◽  
Theoretical Domains Framework ◽  
Decision Makers ◽  
Sampling Frame ◽  
Theoretical Frameworks ◽  
Deceased Organ Donation ◽  
Substitute Decision Makers ◽  
Regulation Model

IntroductionIn Canada, deceased organ donation provides over 80% of transplanted organs. At the time of death, families, friends or others assume responsibility as substitute decision-makers (SDMs) to consent to organ donation. Despite their central role in this process, little is known about what barriers, enablers and beliefs influence decision-making among SDMs. This study aims to explore the experiences and perspectives of SDMs involved in making decisions around the withdrawal of life-sustaining therapies, end-of-life care and deceased organ donation.Methods and analysisSDMs of 60 patients admitted to intensive care units will be enrolled for this study. Ten hospitals across five provinces in Canada in a prospective multicentre qualitative cohort study. We will conduct semistructured telephone interviews in English or French with SDMs between 6 and 8 weeks after the patient’s death. Our sampling frame will stratify SDMs into three groups: SDMs who were not approached for organ donation; SDMs who were approached and consented to donate and SDMs who were approached but did not consent to donate. We will use two complementary theoretical frameworks—the Common-Sense Self-Regulation Model and the Theoretical Domains Framework— to inform our interview guide. Interview data will be analysed using deductive directed content analysis and inductive thematic analysis.Ethics and disseminationThis study has been approved by the Centre Hospitalier de l’Université de Montréal Research Ethics Board. The findings from this study will help identify key factors affecting substitute decision-making in deceased organ donation, reasons for non-consent and barriers to achieve congruency between SDM and patient wishes. Ultimately, these data will contribute to the development and evaluation of tools and training for healthcare providers to support SDMs in making decisions about organ donation.Trial registration numberNCT03850847.

Outcomes of organ donation in brain-dead patient's families: Ethical perspective

2017 ◽  
Vol 26 (1) ◽  
pp. 256-269 ◽  
Author(s):  
Shamsi Ahmadian ◽  
Abolfazl Rahimi ◽  
Ebrahim Khaleghi
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Qualitative Content Analysis ◽  
Organ Procurement ◽  
Healthcare Providers ◽  
Traumatic Experience ◽  
Ethical Review ◽  
Ethical Perspective ◽  
Main Category ◽  
Brain Dead

Background: The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. Objective: The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. Methods: This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. Findings: The main category of the data was “Decision to organ donation: a challenge from conflict to transcendence.” This main category consisted of 10 subcategories and 3 general categories. The general categories were “challenging outcomes,” “reassuring outcomes,” and “transcending outcomes.” Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Conclusion: Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from the tragedy of significant loss, healthcare professionals need to facilitate the process of achieving confidence and transcendence by them.

Non-Heart-Beating Organ Donation: A Defense of the Required Determination of Death

1999 ◽  
Vol 27 (2) ◽  
pp. 126-136 ◽  
Author(s):  
James M. DuBois
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Function ◽  
Medical Treatment ◽  
Organ Donation ◽  
Organ Procurement ◽  
Determination Of Death ◽  
Heart Beating ◽  
The Family ◽  
Transplant Team

The family of a patient who is unconscious and respirator-dependent has made a decision to discontinue medical treatment. The patient had signed a donor card. The family wants to respect this decision, and agrees to non-heart-beating organ donation. Consequently, as the patient is weaned from the ventilator, he is prepped for organ explantation. Two minutes after the patient goes into cardiac arrest, he is declared dead and the transplant team arrives to begin organ procurement. At the time retrieval begins, it is not certain that the patient's brain is dead or that cardiac function cannot be restored. Procurement follows uneventfully, and two transplantable kidneys are retrieved.Many people now consider such cases of non-heart-beating organ donation to be ethically permissible. However, widespread disagreement persists as to how such practices are to be justified and whether such practices are compatible with the Uniform Declaration of Death Act (UDDA). In this paper, I argue that non-heart-beating organ donation can be ethically justified, that in the justified cases the patients are in fact dead, and that the early declarations of death required for such donation do comply with the UDDA.

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