How clinicians discuss patients' donor registrations of consent and presumed consent in donor conversations in an opt-out system: a qualitative embedded multiple-case study.

Sanne P C van Oosterhout Anneke G van der Niet Wilson F Abdo Marianne Boenink Thomas G V Cherpanath Jelle L Epker Angela M M Kotsopoulos Walther N K A Van Mook Hans P C Sonneveld Meint Volbeda Gert Olthuis Jelle L P van Gurp

Published in: Critical care (London, England) (2023)

Donor conversations in an opt-out system are a complex interplay between seemingly straightforward donor registrations and clinician-family interactions. When clinicians are left with concerns regarding patients' consent or families' coping, families are given a larger role in the decision. A strict uniform application of the opt-out system is unfeasible. We suggest incorporating the four previously described routes in clinical training, stimulating discussions across cases, and encouraging public conversations about donation.

Keyphrases

end stage renal disease
chronic kidney disease
healthcare
peritoneal dialysis
prognostic factors
emergency department
advance care planning
patient reported outcomes