Non–heart-beating organ donation: Issues and ethics for the critical care nurse

DeVeaux, Theresa

doi:10.1016/j.jvn.2005.11.004

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…Perhaps the biggest psychological barrier revolves around the determination of death and the decision to withdraw life support (15,25–31). Some participants found the definition of death for DCD to be more ambiguous than brain death.…”

Section: Introductionmentioning

confidence: 99%

An Empirical Examination of the Antecedents of the Acceptance of Donation After Cardiac Death by Health Care Professionals

D’Alessandro

Peltier

Phelps

2008

American Journal of Transplantation

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Findings are reported from a US Department of Health and Human Services (DHHS) funded study to identify barriers to increasing support for donations after cardiac death by health professionals. A donations after cardiac death (DCD) acceptance model is conceptualized and tested via 806 survey responses from certified requestors, all of whom had their identities protected through Institutional Review Board (IRB) protocol. The overall model was significant and explained 35% of the variation in DCD support. Greater knowledge about DCD, greater trust in the organ procurement organization (OPO) and a belief that futility has been reached were all positively associated with DCD acceptance. Negative perceptions of DCD versus brain death, transitioning from caregiving to donation advocate, concerns about the DCD process and the idea that DCD leads to active participation in the death reduced its support. The three greatest impediments to support of DCD exist when health professionals feel they are playing an active role in killing the patient, that a state of death has not yet been reached, and that DCD has more psychological barriers than does the brain death donation process. Opportunities and strategic initiatives are discussed to overcome these barriers, including the value of communication and education initiatives and the need for well-trained requestors. The implementation of these strategic guidelines helped to increase the number of DCD donors by 225%.

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Section: Introductionmentioning

confidence: 99%

An Empirical Examination of the Antecedents of the Acceptance of Donation After Cardiac Death by Health Care Professionals

D’Alessandro

Peltier

Phelps

2008

American Journal of Transplantation

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“…Unlike brain death donation, which has widespread acceptance in the healthcare community, DCD still carries ethical and psychological concerns (4). Common criticisms of DCD focus on concerns about whether the state of irreversibility exists, concerns that sufficient efforts are undertaken to save donors, conflict of interest between care providers and transplant teams, and a range of potential conflicts arising from the decision to remove life support (5)(6)(7)(8)(9)(10). These concerns persist despite strong ethical support for DCD across numerous healthcare agencies (11)(12)(13)(14)(15).…”

mentioning

confidence: 99%

Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals*

D’Alessandro

Peltier

Phelps³

2008

Critical Care Medicine

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Our findings provide a better understanding of healthcare professionals' knowledge, attitudes, and behaviors regarding DCD. Understanding these issues is critical to the implementation of strategic plans for DCD programs. One of the biggest barriers to overcome is a lack of knowledge of DCD, which leads to misperceptions, which in turn contribute to negative attitudes and/or discomfort by healthcare professionals. Communication efforts that are able to educate healthcare professionals and eliminate misperceptions will increase support for DCD. Key to future success requires confident and well-trained DCD requesters.

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“…These new laws permitted better procurement of viable organs because circulation and breathing were maintained mechanically. 3 By the 1990s, there was an alarming decrease in organs available for transplantation. By the mid-1990s, nonYheart-beating donor was reintroduced and renamed as DCD.…”

Section: Ethical Concerns Of Organ Donation After Cardiac Deathmentioning

confidence: 99%

“…The debriefing session allows staff to discuss the process, voice any concerns that they have, find resolution to any problems, and provide a time for them to vent their feelings. 3 For DCD programs to be successful and rewarding for everyone involved, it is imperative that good communication exists between the health care teams and the families of the potential donor. 14 For the potential donor's families, it is also vital that they receive guidance with the utmost respect for their wishes involving the deceased.…”

Section: Implications For Advanced Practice Nursesmentioning

confidence: 99%

“…20 By being a part of the protocol development, APNs can ensure that there is a clear and concise definition of DCD and a detailed decision algorithm that also includes a plan for those who do not meet the criteria once support is withdrawn. 3 Advanced practice nurses and CCNs also need to be aware of the applicable laws and regulations when developing DCD protocols at their institution. This, in turn, will help to decrease the taboo associated with DCD and give the health care providers a peace of mind knowing that the patient is being cared for in an ethical and respectful way, even in the event that the patient does not die in the allotted time and is unable to be a donor.…”

Section: Implications For Advanced Practice Nursesmentioning

confidence: 99%

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Donation After Cardiac Death

Everidge

2012

Dimensions of Critical Care Nursing

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Donation after cardiac death has always presented ethical concerns among health care providers. As advanced practice nurses and critical care nurses, it is our responsibility to ensure that health care providers and families are educated about the process and that we remain advocates for the potential donors. This article reviews the donation after cardiac death process, provides a donation after cardiac death hypothetical case report and its outcome, and addresses the ethical concerns associated with donation after cardiac death from both opponents' and proponents' points of view. It will also discuss the benefits of obtaining a palliative care consult and the roles of the advanced practice nurse in the care of the potential donor.

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Non–heart-beating organ donation: Issues and ethics for the critical care nurse

Cited by 8 publications

References 11 publications

An Empirical Examination of the Antecedents of the Acceptance of Donation After Cardiac Death by Health Care Professionals

An Empirical Examination of the Antecedents of the Acceptance of Donation After Cardiac Death by Health Care Professionals

Understanding the antecedents of the acceptance of donation after cardiac death by healthcare professionals*

Donation After Cardiac Death

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