Attitude of health care professionals to brain death: influence on the organ donation process

Abstract

The acceptance and application of the concept that brain death is a valid determination of death is the central issue in organ donation. However, whether attitude to brain death of health care professionals influences the organ procurement process has not been systematically studied. Questionnaires were distributed to health care professionals involved in the organ procurement process (intensive care, internal medicine, emergency room, anesthesia) in all hospitals in Israel. Attitude to brain death (defined as positive if the respondent accepted brain death as a valid determination of death, negative or do not know) and level of comfort in performing key donor-related tasks were analyzed. A total of 2366 completed questionnaires were returned (629 doctors and 1737 nurses; response rate 60.3%). Overall, 78.9% of respondents had a positive attitude to brain death. This was significantly associated with increasing age, higher professional status and was most prevalent amongst intensive care unit staff (p < 0.001 for all variables). These respondents felt significantly more comfortable informing the transplant coordinator of a potential donor, explaining brain death to the family, raising the subject of organ donation, approaching the family about donation and providing support to the grieving family. In addition, they believed the transplant coordinator should be involved early in the donation process. The understanding and acceptance of brain death as a valid determination of death was associated with a positive effect on the level of comfort of health care professionals in performing key donor-related tasks. Reinforcing a positive attitude to brain death among health care professionals may facilitate the procurement process.