Limits...
Request for organ donation without donor registration: a qualitative study of the perspectives of bereaved relatives.

de Groot J, van Hoek M, Hoedemaekers C, Hoitsma A, Schilderman H, Smeets W, Vernooij-Dassen M, van Leeuwen E - BMC Med Ethics (2016)

Bottom Line: Half of those who refused consent for donation mentioned afterwards that it could have been an option.The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures.Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances.

View Article: PubMed Central - PubMed

Affiliation: Radboud Institute for Health Sciences, Radboud University Medical Center, DGVP 20, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. Jack.deGroot@radboudumc.nl.

ABSTRACT

Background: In the Netherlands, consent from relatives is obligatory for post mortal donation. This study explored the perspectives of relatives regarding the request for consent for donation in cases without donor registration.

Methods: A content analysis of narratives of 24 bereaved relatives (14 in-depth interviews and one letter) of unregistered, eligible, brain-dead donors was performed.

Results: Relatives of unregistered, brain-dead patients usually refuse consent for donation, even if they harbour pro-donation attitudes themselves, or knew that the deceased favoured organ donation. Half of those who refused consent for donation mentioned afterwards that it could have been an option. The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures.

Conclusion: Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances. It is anticipated that the number of consenting families could be enlarged by examining the experience of decoupling and offering the possibility of consent for donation after circulatory death if families refuse consent for donation after brain-death.

No MeSH data available.


Related in: MedlinePlus

Model of factors influencing the decision towards refusal of consent for donation, although the deceased was in favour of organ donation. Model for families who did not comply with the deceased’s preferences (type B, see Table 2). Important factors are denoted in bold script, absent factors in faded script. Abbreviations: DCD = donation after circulatory death; DBD = donation after brain death; OD = organ donation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4940748&req=5

Fig4: Model of factors influencing the decision towards refusal of consent for donation, although the deceased was in favour of organ donation. Model for families who did not comply with the deceased’s preferences (type B, see Table 2). Important factors are denoted in bold script, absent factors in faded script. Abbreviations: DCD = donation after circulatory death; DBD = donation after brain death; OD = organ donation

Mentions: In additive figures, this model was applied for respondent types who made a decision that deviated from the deceased’s preference (Figs. 4 and 5) and respondents who did not know the preference of the eligible donor (Figs. 6 and 7). Respondents who adhered to the deceased’s preference are not shown. Differences in starting situations gave a different weight to the contributing factors. The weight respondents’ gave to these factors is emphasised with boldness for important factors, and fading for absent factors.Fig. 4


Request for organ donation without donor registration: a qualitative study of the perspectives of bereaved relatives.

de Groot J, van Hoek M, Hoedemaekers C, Hoitsma A, Schilderman H, Smeets W, Vernooij-Dassen M, van Leeuwen E - BMC Med Ethics (2016)

Model of factors influencing the decision towards refusal of consent for donation, although the deceased was in favour of organ donation. Model for families who did not comply with the deceased’s preferences (type B, see Table 2). Important factors are denoted in bold script, absent factors in faded script. Abbreviations: DCD = donation after circulatory death; DBD = donation after brain death; OD = organ donation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940748&req=5

Fig4: Model of factors influencing the decision towards refusal of consent for donation, although the deceased was in favour of organ donation. Model for families who did not comply with the deceased’s preferences (type B, see Table 2). Important factors are denoted in bold script, absent factors in faded script. Abbreviations: DCD = donation after circulatory death; DBD = donation after brain death; OD = organ donation
Mentions: In additive figures, this model was applied for respondent types who made a decision that deviated from the deceased’s preference (Figs. 4 and 5) and respondents who did not know the preference of the eligible donor (Figs. 6 and 7). Respondents who adhered to the deceased’s preference are not shown. Differences in starting situations gave a different weight to the contributing factors. The weight respondents’ gave to these factors is emphasised with boldness for important factors, and fading for absent factors.Fig. 4

Bottom Line: Half of those who refused consent for donation mentioned afterwards that it could have been an option.The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures.Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances.

View Article: PubMed Central - PubMed

Affiliation: Radboud Institute for Health Sciences, Radboud University Medical Center, DGVP 20, PO Box 9101, 6500, HB, Nijmegen, The Netherlands. Jack.deGroot@radboudumc.nl.

ABSTRACT

Background: In the Netherlands, consent from relatives is obligatory for post mortal donation. This study explored the perspectives of relatives regarding the request for consent for donation in cases without donor registration.

Methods: A content analysis of narratives of 24 bereaved relatives (14 in-depth interviews and one letter) of unregistered, eligible, brain-dead donors was performed.

Results: Relatives of unregistered, brain-dead patients usually refuse consent for donation, even if they harbour pro-donation attitudes themselves, or knew that the deceased favoured organ donation. Half of those who refused consent for donation mentioned afterwards that it could have been an option. The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures.

Conclusion: Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances. It is anticipated that the number of consenting families could be enlarged by examining the experience of decoupling and offering the possibility of consent for donation after circulatory death if families refuse consent for donation after brain-death.

No MeSH data available.


Related in: MedlinePlus