Das Angehörigengespräch im Rahmen der postmortalen Organspende aus der Sicht von Ärzt:innen und Pflegenden: Ergebnisse einer qualitativen Interviewstudie aus Österreich

Austria’s strict presumed consent law allows postmortem organ donation without a patient’s objection during life. If an entry in the opting-out registry is absent, the family is consulted about the deceased’s presumed willingness for donation.

To describe the practical implementation of presumed consent legislation in Austria, relevant aspects of the conversation with relatives and the role of the family in the decision process on postmortem organ donation should be identified.

A total of ten guided expert interviews with physicians and nurses from an Austrian hospital were conducted, wherein a qualitative content analysis according to Mayring using MAXQDA was performed.

Challenges in determining the patient’s presumed willingness in conversation with relatives may arise due to different cultures/religions, disagreement, and inability of familial decision-making due to grief and the difficulty in understanding the concept of brain death. Therefore, good preparation, enough time, interdisciplinary cooperation, building trust and professional communication, and addressing relatives’ questions and needs by healthcare staff in an appropriate setting are necessary. Communication with relatives in the context of postmortem organ donation is stressful for both healthcare professionals and families.

Based on the results, recommendations include applying the communication guideline of Gesundheit Österreich GmbH, extending it with legal information, and providing regular communication training for health staff. In addition, nationwide education on the importance of intrafamilial discussion is required.