Attitudes of intensive care and emergency physicians in Australia with regard to the organ donation process: A qualitative analysis. (September 2020)

• Record Type: Journal Article
• Authors: Macvean, Emily; Yuen, Eva YN; Tooley, Gregory; Gardiner, Heather M; Knight, Tess
• Is Part Of: Journal of health psychology. Volume 25:Number 10/11(2020)
• Page Start: 1601
• Page End: 1611
• Publication Date: 2020-09
• Subjects: clinical practice patterns -- end-of-life care -- ethical issues -- healthcare provider attitudes -- organ and tissue donation; Clinical health psychology -- Periodicals; 613.019
• DOI: 10.1177/1359105318765619
• Languages: English
• ISSNs: 1359-1053

Abstract

Specialized hospital physicians have direct capacity to impact Australia's sub-optimal organ donation rates because of their responsibility to identify and facilitate donation opportunities. Australian physicians' attitudes toward this responsibility are examined. A total of 12 intensive care unit and three emergency department physicians were interviewed using a constructionist grounded theory and situational analysis approach. A major theme emerged, related to physicians' conflicts of interest in maintaining patients'/next-of-kin's best interests and a sense of duty-of-care in this context. Two sub-themes related to this main theme were identified as follows: (1) discussions about organ donation and who is best to carry these out and (2) determining whether organ donation is part of end-of-life care; including the avoidance of non-therapeutic ventilation; and some reluctance to follow clinical triggers in the emergency department. Overall, participants indicated strong support for organ donation but would not consider it part of end-of-life care, representing a major obstacle to the support of potential donation opportunities. Findings have implications for physician education and training. Continued efforts are needed to integrate the potential for organ donation into end-of-life care within intensive care units and emergency departments.