Exploring the experiences and perspectives of emergency physicians on brain death organ tissue donation after the Life-Sustaining Treatment Decision Act

Abstract

Background : This study explored emergency physicians’ experiences and perspectives related to brain death organ tissue donation (OTD) after the enforcement of the Life-Sustaining Treatment (LST) Decision Act in Korea. Methods : Using the Braun and Clarke thematic analysis method, this qualitative study analyzed interview data—comprising experiences and perspectives of brain death OTD since the LST Decision Act—of 10 emergency physicians who specialized in targeted temperature management (TTM) and cared for post-cardiac arrest patients. Results : Data analysis revealed 13 subthemes and 5 themes: the LST Decision Act is easier to explain to family members than brain death OTD, but it does not fit well in an emergency medical setting; many family members decide to stop LST even before physicians mention brain death or OTD; family members view stopping LST as being about comforting patients without bothering them, and decision-makers are therefore no longer willing to choose OTD; stopping LST does not always result in brain death, but cases of brain death are preceded by stopping LST; and since the LST Decision Act, the number of TTM cases and potential brain death donors has decreased. Conclusions: Unless a supplementary policy that connects stopping LST to brain death OTD is prepared, the withdrawal of LST in patients resuscitated after cardiac arrest is expected to continue, and brain death OTD is expected to decrease.

Keywords

• life-sustaining treatment; organ donation; tissue and organ procurement; emergency physician