Korean J Transplant.  2022 Mar;36(1):29-36. 10.4285/kjt.22.0005.

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

Affiliations
  • 1Department of Emergency Medicine, Dong-A University College of Medicine, Busan, Korea
  • 2Department of Medical Education, Dong-A University College of Medicine, Busan, Korea
  • 3Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 4Department of Medical Education, Gachon University College of Medicine, Incheon, Korea
  • 5Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
  • 6Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea
  • 7Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Korea
  • 8Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Korea
  • 9Department of Medical Education, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 10Department of Emergency Medicine, Wonju Severance Christian Hospital, Wonju, Korea

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.

Keyword

Life-sustaining treatment; Organ donation; Tissue and organ procurement; Emergency physician
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