Doctors' attitudes to organ donation

Abstract

Background: There is an increasing need for organs for transplantation purposes. Knowledge and attitudes among the medical team may affect the donation process. When respiration and cardiac activity are being sustained by artificial means, Norwegian law requires angiographic evidence of cessation of cerebral circulation as well as clinical examination before an organ donation can be carried out. We wished to survey Norwegian doctors' attitudes to organ donation and how donation processes are being addressed.

Material and method: A questionnaire with pre-defined response alternatives was distributed to doctors in intensive-care units as well as to specialists and junior registrars in neurosurgery in Norwegian donor hospitals in 2008-2009.

Results: Altogether 435 doctors (55%) returned a completed questionnaire. A total of 315 of 420 (75%) responded that they would consider initiating organ-preserving treatment when there is no more hope for the patient, while 18% were uncertain and 7% responded that they would not consider this option. Altogether 68 of 424 (16%) maintained that if an organ donation was relevant and current legislation could be disregarded, clinical diagnostics would be sufficient to establish a diagnosis of death. Another 22% were uncertain, while 62% were of the opinion that clinical diagnostics would be insufficient. A total of 258 of 416 (62%) reported that in their opinion, the next of kin most often could understand the implications of total destruction of the brain when this was explained to them.

Interpretation: Future teaching should emphasise the opportunity for organ-preserving treatment in cases where a fatal outcome is expected.