NL
Many doctors find it a challenge: informing next of kin that a "no objection" donor registration means consent for organ and tissue donation. PhD student Sanne van Oosterhout and her team conducted qualitative research into the interview process. For this purpose, 29 donation interviews were analyzed in eight hospitals and the professionals and family members involved were interviewed afterwards.
Since July 2020, the Active Donor Registration System has been in force in the Netherlands. New in it is the "no objection" donor registration, which applies automatically if no explicit choice has been communicated. How do doctors discuss this donor registration with the family? For this purpose, the researchers selected 15 donation interviews.
The study reveals that physicians have an individual starting point in donation discussions. Their own views on donation, previous experiences with families and knowledge of the new donor law play a role. Doctors conducted the donation conversation through four routes: from sticking to the patient's registered wish to following more closely the wishes of the next of kin. Especially the "no-objection" registration leads to more uncertainty. Doctors experience the feeling of having to balance between five goals: following legislation, fulfilling the potential donor's wish, reaching consensus with the family and avoiding conflict, providing optimal grief counseling for the family, and making more tissues and organs available. This makes the donation conversation complex.
If the family is aware of their loved one's donor registration, the conversation goes more smoothly for both doctors and families. Public education about registration and the donation process is therefore crucial. This research will be used to optimize education for physicians. The new donor law is relatively new, so many physicians were still untrained or inexperienced with "no-objection" conversations. Training, mutual exchange and peer review, and reflection on the four routes and one's own actions are important.
Read the article here: https://rdcu.be/dik8H van Oosterhout, S.P.C., van der Niet, A.G., Abdo, W.F. et al. How clinicians discuss patients' donor registrations of consent and presumed consent in donor conversations in an opt-out system: a qualitative embedded multiple-case study. Crit Care 27, 299 (2023).