[Discussing tissue donation with relatives of deceased patients is difficult. Interview study among physicians]

The current Swedish transplant act (1995:831), which in contrast to the former law covers the procurement of tissues came into force on July 1, 1996. Eleven doctors and nurses were interviewed concerning their experiences of discussing tissue donation with bereaved relatives. The interviews revealed that breaking news about a patient's death was considered a routine matter, whereas discussing donation with relatives was regarded a difficult and unpleasant task. In general, the medical staff was not sufficiently familiar with the new law, and reported the lack of routines and guidelines in these matters as a problem. Many of the doctors felt they needed more psychological support and more opportunities to discuss ethical questions; the nurses asked for more information about donation and transplantation, and about ethics. In conclusion, there is a need for training in the communication skills involved in approaching bereaved relatives on the subject of tissue donation. There is also a need for a better understanding of the importance of providing psychological support to medical staff on the part of chiefs and health care authorities.