Organ donation education in the ICU setting: a qualitative and quantitative analysis of family preferences

Michetti, Christopher P.; Newcomb, Anna B.; Thota, Vihitha; Liu, Chang

doi:10.1016/j.jcrc.2018.08.032

Cited by 8 publications

(16 citation statements)

References 11 publications

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“…In a recent survey of 118 family members of patients in the ICU, only 32% could answer four questions about organ donation correctly [27]. A majority of FDMs reported that receiving more information about donation while their loved one was in the ICU would have helped donation decision-making [27]. This is consistent with other studies that have shown higher authorization rates among FDMs who received more donation-relevant information [15,28,29].…”

Section: Reasons To Refuse or Accept Organ Donation: Key Factors Inflsupporting

confidence: 75%

“…FDMs have consistently expressed a need for additional knowledge and accurate information about organ donation to aid in their decision-making [26]. In a recent survey of 118 family members of patients in the ICU, only 32% could answer four questions about organ donation correctly [27]. A majority of FDMs reported that receiving more information about donation while their loved one was in the ICU would have helped donation decision-making [27].…”

Section: Reasons To Refuse or Accept Organ Donation: Key Factors Inflmentioning

confidence: 99%

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A narrative review of family members’ experience of organ donation request after brain death in the critical care setting

et al. 2019

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Family members of critically ill patients suffer from high levels of anxiety and depression in the ICU, and are at risk of developing post-ICU syndrome following ICU discharge. In the case of brain death, and potential organ donation, the family is at the center of the decision process: within a limited time frame, the family will be informed that the patient is brain dead and will be approached about potential organ donation. Family experience with organ donation has been the topic of several research papers allowing to gain knowledge about family members' experience of organ donation, emphasizing specific needs, adequate support and pointing out gaps in current delivery of family-centered care. In this review, experts clinicians and researchers present the various legal systems regarding family implication in organ donation decisions; describe factors that influence the decision-making process; highlight family perspectives of care and respect for potential donors in the ICU environment; describe the impact of organ donation discussions and decisions on post-ICU syndrome; and suggest communication skills and support to be developed in the future. A research agenda for the next decade is also encouraged. Overall, challenges remain and concern all persons involved in the process, ICU doctors and nurses, the organ procurement organization, family members and, in some cases, the patients themselves. Looking at the big picture will provide opportunities for further improvements.

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Section: Reasons To Refuse or Accept Organ Donation: Key Factors Inflsupporting

confidence: 75%

Section: Reasons To Refuse or Accept Organ Donation: Key Factors Inflmentioning

confidence: 99%

A narrative review of family members’ experience of organ donation request after brain death in the critical care setting

et al. 2019

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“…Many SDMs have incomplete knowledge of the organ donation process. 44 In a study with SDMs, Sarti et al 45 revealed that informational gaps and ''lingering unanswered questions'' remained long after the donation experience. Recommendations to encourage discussions around organ donation have been forwarded by other authors.…”

Section: Legal and Ethical Conflictmentioning

confidence: 99%

Family veto in organ donation: the experiences of Organ and Tissue Donation Coordinators in Ontario

Anthony

Lin

Pol

et al. 2021

Can J Anesth/J Can Anesth

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Purpose In Ontario, an individual's registered wish for organ donation is legally valid consent following death. Family veto occurs when the deceased donor's substitute decision-maker (SDM) overrides this consent to donate, evoking a legal and ethical conflict. The objective of this study was to examine the experiences of Organ and Tissue Donation Coordinators (OTDCs) working with SDMs who vetoed a deceased donor's consent for organ donation. Methods Qualitative focus groups were conducted with ten OTDCs in Ontario, Canada who reported experience with family veto. An interpretative phenomenological approach informed data analysis. Themes emerged through team consensus and were further refined through collaborative and reflexive engagement. This article is accompanied by an editorial. Please see Can J Anesth 2021, this issue.

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“…7,11 However, an estimated 50% of families do not know the deceased's preferences, and are influenced instead by factors ranging from the context of the request (e.g., timing, background of the requestor), to pre-existing characteristics of the decisionmaker (e.g., demographics, beliefs about death, views on organ donation). [7][8][9]12,13 By and large, these factors overlap greatly with those predicting donation choices for the self. 9,14,15 Although this overlap may suggest similarity in the self-versus family-decision making process, it cannot explain the well-documented discrepancy between: (1) high public endorsement of organ donation (for the self), versus (2) low rates of family acceptance (when deciding for next-of-kin).…”

Section: Introductionmentioning

confidence: 99%

Comparing organ donation decisions for next-of-kin versus the self: Results of a national survey

Liu

Chen

Anwar

et al. 2021

Preprint

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Objectives: Intensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker's mindset. This focused on: (1) how decisions compare when made on behalf of a relative (versus the self); and (2) confidence in decisions made for family members. Design: Cross-sectional survey in Singapore. Setting: Participants were recruited from community settings via door-to-door sampling and community eateries. Participants: 973 adults who qualified as organ donors in Singapore. Results: Although 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative's. Using machine learning, we found that consistency was predicted by: (i) religion, and (ii) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative's were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives' wishes upon death. Conclusions: These findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker's mindset (e.g., overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.

show abstract

Organ donation education in the ICU setting: a qualitative and quantitative analysis of family preferences

Cited by 8 publications

References 11 publications

A narrative review of family members’ experience of organ donation request after brain death in the critical care setting

A narrative review of family members’ experience of organ donation request after brain death in the critical care setting

Family veto in organ donation: the experiences of Organ and Tissue Donation Coordinators in Ontario

Comparing organ donation decisions for next-of-kin versus the self: Results of a national survey

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