Barriers to Brain Death Notifications From Emergency Departments

Emergency departments (EDs) are a new focus of interest in recent years as a possible solution for increasing organ donations, as, EDs are full of missed opportunities. In this study, we aimed to determine the barriers to the identification and referral by emergency medicine physicians (EMPs) of potential brain death (BD) cases.

The participants of the study consist of 252 EMPs who had answered the questionnaire sent via e-mail.

The following causes were found in the questionnaire: (1) negative attitudes and lack of knowledge about organ donation in society (63.1%); (2) religious beliefs (57.5%); (3) family refusal (57.1%); (4) disruption of bodily integrity (45.6%); (5) inadequate knowledge of doctors (50.4%); (6) difficulties in predicting the prognosis of the patient and diagnosing BD in EDs (40.1%); (7) fear of negative reactions from relatives of patients (37.7%); (8) the absence of an organ procurement unit (OPU) (36.5%); (9) lack of ideal candidates (27%); (10) increased workload in EDs (23.8%); and (11) fear of legal problems arising (23.8%). Of the participants, 42.9% stated that there was an OPU in their hospital. Of the participants, 15.8% reported that they have good communication with the OPU.

Negative attitudes and lack of knowledge about organ donation in society, religious beliefs, inadequate knowledge of EMPs, and the absence of an OPU in hospitals are important barriers to organ donor notification from EDs. Increasing social awareness and increasing of the level of knowledge of EMPs and close cooperation between OPU and EDs will significantly contribute to the increase of organ donor notifications from EDs.