大象传媒

Aud Or酶y, Kjell Erik Str酶mskag and Eva Gjengedal(Authors in bold from the Department of Global Health and Primary Care, (UiB)).
Nurs Ethics April 2014

Aud Or酶y, Kjell Erik Str酶mskag, Eva Gjengedal(Authors in bold from the Department of Global Health and Primary Care, (UiB)).
Intensive and Critical Care Nursing 2013

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Miracle to modern medicine

A 鈥榤iracle of modern medicine鈥�, 鈥渙rgan donation and transplantation have made it possible to both save life and improve the quality of life for a large number of patients鈥�. However, in Norway, as in most other countries, there are increasingly growing organ shortages and lengthening waiting lists. Authors Aud Or酶y and Eva Gjengedal report from studies investigation the ethical challenges involved for healthcare professionals.

While physicians are responsible for both the timing and raising of the issue of organ donation, all healthcare professionals are implicated in the ethical challenges involved in caring for patients, potential donors and their families. The 2 papers explore the experiences of healthcare professionals involved in situations where brain death is an inevitable outcome of a patient鈥檚 condition, and they must broach the issue of organ donation with the families.

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Organ donation a national priority

While national policies on organ donation and transplantation vary in different countries, the authors highlight that, in Norway, organ donation is a national priority. In addition, the Norwegian 鈥楾ransplant Act (1973)鈥� assumes presumed consent. However, the regulations stipulate that, if medical conditions allow, the next-of-kin should be informed and asked. Clinical practice is that next-of-kin always is asked whether they are familiar with the deceased's attitude to organ donation. Donation practice involves routines, specified in the 鈥楶rotocol for Organ Donation鈥�. Unlike many countries, Norway does not have an organ donation registry. It is considered sufficient if donation wishes have been expressed to close relatives.

The study used participant observations and in-depth interviews to explore healthcare professionals鈥� experiences during end-of-life decision-making and care. It is a situation where 鈥減rofessional ethics may be threatened by [the] more pragmatic and utilitarian arguments contained in [Norwegian] regulations and the Norwegian Transplant Act鈥�. In addition, 鈥渃aring for organ donors requires skills that are in conflict with traditional [] care.鈥�

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Ethical issues should be openly discussed

The authors鈥� comprehensive analyses of this sensitive area led to some conclusions and implications for healthcare practice.听 They state that 鈥渃aring by healthcare professionals means more than simply maintaining life; it is about supporting a dignified life.鈥� Among other things, they stress the need to facilitate the development of reflection and moral reasoning through open discussion and exploration. They also suggest the mentoring of less experienced personnel by more experienced ones.

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Some links relating to Norwegian regulations (in Norwegian)