Organ donation in principle and in practice: tensions and healthcare professionals’ troubled consciences

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Abstract

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. However, 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 common sense 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.

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Acknowledgements

The authors wish to express their sincere gratitude to all the participants in the study who generously gave up their time to be interviewed.

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Correspondence to Laura L. Machin.

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The original online version of this article was revised: In the original publication of the article, the second author’s affiliation was published incorrectly and it has been updated.

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Machin, L.L., Cooper, J., Dixon, H. et al. Organ donation in principle and in practice: tensions and healthcare professionals’ troubled consciences. BioSocieties (2021). https://doi.org/10.1057/s41292-020-00219-z

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Keywords

  • Conscientious objection
  • Organ donation
  • Organ donation in principle
  • Organ donation in practice
  • Tensions
  • Troubled consciences