Donation Studies

AimsTo explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice.DesignInterpretive phenomenology was used to guide this study.Data sourcesData were collected from 2016 ‐ 2017 through one‐on‐one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings.Review methodsIterative, phased analysis using line‐by‐line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO.ResultsConscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses’ conscience are needed in Canada and across the profession to support ...

Background and objective: Solid organ donation remains low in Australia; however, donation after circulatory death (DCD) bolsters rates and is associated with good short-and long-term clinical outcomes among recipients, especially in lung and kidney recipients. However, its reintroduction is met with resistance within hospitals. The aim of the present study was to develop a greater understanding of DCD perceptions among staff involved. Methods: This descriptive exploratory study incorporated open-ended and scaled questions with intensive care staff at a public tertiary teaching hospital in Australia. Interviews were digitally recorded and transcribed verbatim before thematic analysis. Quantitative responses were assessed using a 10point Likert scale. Results: Twelve participants were interviewed. Responses to the Likert scale questions were averaged. Donation after brain death was unanimously accepted (average ¼ 10.0), whereas DCD acceptance was lower but remained supported (average ¼ 8.8). Interview responses generated five themes, each containing subthemes. Respondents had concerns with DCD where perceptions existed that DCD would increase family distress, from either timeframes not being met or logistical delays. A second major source of concern stemmed from personal conflict relating to their role. There was difficulty transitioning from primarily sustaining life or facilitating palliation alone to advocating for DCD, especially where there was perceived potential for deviations from standard palliation in analgesia, sedation, and investigations. Overall, concerns were overcome by reliance on a supportive work environment, rationalisation of concerns over time, and reliance on protocols. Conclusions: Supportive leadership within the hospital's intensive care unit meant DCD occurred with minimal institutional resistance. However, some individual concerns surrounding DCD were identified. These may be present and amplified in other centres. More study is required in centres where institutional resistance to DCD is identified so that DCD may be further promoted to expand the donor pool.

This was a pilot study as it used a newly devised survey tool to determine the views and attitudes of undergraduate nursing students to the shortage of organs for transplantation purposes, with this survey also gaining insight into any possible moral distress. The survey tool was distributed to 134 undergraduate nursing students who attended a mandatory nursing research course, with 104 (77.6%) participating. The data were analyzed through content analysis, with three main themes identified: right to life, impact on others, and emotions. A high level of moral distress among the participants were identified, which confirm the necessity of future studies on this topic.

Aims: To explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice. Design: Interpretive phenomenology was used to guide this study. Data sources: Data were collected from 2016-2017 through one-on-one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings. Review methods: Iterative, phased analysis using line-by-line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO. Results: Conscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses' conscience are needed in Canada and across the profession to support nurses to address their issues of conscience in professional practice. Conclusion: Ethical meaning emerges for nurses in their lived experiences of encountering serious ethical issues that they need to professionally address, by way of conscience-based COs. Impact: This is the first study to explore what conscience means to nurses, as shared by nurses themselves and in the context of CO. Nurse participants expressed that support from leadership, regulatory bodies, and policy for nurses' conscience rights are indicated to address nurses' conscience issues in practice settings.

BackgroundCo‐production of research into public health services has yet to demonstrate tangible benefits. Few studies have reported the impact of co‐production on research outcomes. The previous studies of organ donation have identified challenges in engaging with public organizations responsible, gaining ethical approval for sensitive studies with the recently bereaved and difficulty in recruiting bereaved family members who were approached about organ donation.ObjectiveTo address these challenges, we designed the first large co‐productive observational study to evaluate implementation of a new system of organ donation in Wales. This paper outlines the co‐productive strategies that were designed to overcome known methodological challenges and reports what impact they had on resolving these challenges.DesignTwo‐year co‐produced study with multiple stakeholders with the specific intention of maximizing engagement with the National Health Service arm in Wales responsible for organ don...

The critical pathway of deceased donation provides a systematic approach to the organ donation process, considering both donation after cardiac death than donation after brain death. The pathway provides a tool for assessing the potential of deceased donation and for the prospective identification and referral of possible deceased donors.

The critical pathway of deceased donation provides a systematic approach to the organ donation process, considering both donation after cardiac death than donation after brain death. The pathway provides a tool for assessing the potential of deceased donation and for the prospective identification and referral of possible deceased donors.

There has been a shift in the language of responsibility because the threat of malpractice litigation is encouraging physicians to assume a more responsible role in caring for their patients. Consequently, instead of paying attention to the moral dimension of this principle, professionals are sometimes much more concerned about legal repercussions. This article aims therefore at analyzing the recent literature on responsibility in intensive care, focusing on its ethical dimension. By analyzing the contributions of Emmanuel Levinas, Hans Jonas and Paul Ricoeur, who placed special emphasis on the theme of "moral responsibility", we will attempt to shed some light on this ethical principle within the specific context of Intensive Care Medicine. This paper underlines the importance of responsibility in order to draw attention to the need to establish an appropriate balance between autonomy and self/other-oriented responsibilities. A tridimensional approach is suggested to frame responsibility within the context of intensive care.

The critical pathway of deceased donation provides a systematic approach to the organ donation process, considering both donation after cardiac death than donation after brain death. The pathway provides a tool for assessing the potential of deceased donation and for the prospective identification and referral of possible deceased donors.

The critical pathway of deceased donation provides a systematic approach to the organ donation process, considering both donation after cardiac death than donation after brain death. The pathway provides a tool for assessing the potential of deceased donation and for the prospective identification and referral of possible deceased donors.

This study investigated ethical conflicts experienced by intensive care unit (ICU) healthcare professionals working in a regional hospital, Limpopo province of South Africa. Setting: The study was conducted at a rural public regional hospital in Vhembe district, Limpopo Province. Communities served by the hospital are poor and medically uninsured. Methods: This study adopted a qualitative, exploratory and descriptive design. The target population comprised Health care professionals working in an ICU of the regional hospital. Purposive sample was selected and 17 unstructured interviews were conducted. Tesch's method of data analysis was used. Ethical considerations were adhered to. Results: Patients' care needs were compromised because of the unavailability of beds and high-technology equipment, such as well-functioning ventilators. Doctors were not having the necessary skills required in the ICU as the majority were on community service/internship and nurses acted beyond their scope of practice because of a lack of adequately trained intensive care specialists. Infection control practices were overlooked and 'use once' pieces of equipment were reused. Conflicting values between nurses, patients and family of patients exist. Conclusion: Lack of resources compromises provision of optimal and intensive care. Patients were prone to infections and their safety might have been compromised.

This study investigated ethical conflicts experienced by intensive care unit (ICU) healthcare professionals working in a regional hospital, Limpopo province of South Africa. Setting: The study was conducted at a rural public regional hospital in Vhembe district, Limpopo Province. Communities served by the hospital are poor and medically uninsured. Methods: This study adopted a qualitative, exploratory and descriptive design. The target population comprised Health care professionals working in an ICU of the regional hospital. Purposive sample was selected and 17 unstructured interviews were conducted. Tesch's method of data analysis was used. Ethical considerations were adhered to. Results: Patients' care needs were compromised because of the unavailability of beds and high-technology equipment, such as well-functioning ventilators. Doctors were not having the necessary skills required in the ICU as the majority were on community service/internship and nurses acted beyond their scope of practice because of a lack of adequately trained intensive care specialists. Infection control practices were overlooked and 'use once' pieces of equipment were reused. Conflicting values between nurses, patients and family of patients exist. Conclusion: Lack of resources compromises provision of optimal and intensive care. Patients were prone to infections and their safety might have been compromised.

The UK government and NHS Blood and Transplant have introduced a number of policies and organisational changes to the organ donation system following the 2008 recommendations of the Organ Donor Taskforce, which aim to increase the number of available donor organs and tackle transplant waiting lists. Little is known about how these policy and organisational shifts influence how healthcare professionals experience delivering end of life care in the context of organ donation. In this paper, we examine ICU, Emergency Medicine, and Theatre staff’s experiences of organ donation in one NHS Trust following the 2008 changes. We focus upon their decision-making when caring for patients at the end of life to highlight the tensions between health professionals' beliefs-in-principle about organ donation and their everyday moral and commonsense practices when caring for patients at the end of life. We explore how we might understand and interpret this ‘troubling’ of organ donation through applying the concept of ‘conscience’, and consider whether a conscientious objection around organ donation could exist.