Experience of Families Facing Emergent Donation Procedures: A Qualitative Analysis of Donor Relatives’ Perceptions of “Intensive Care to Facilitate Organ Donation”

Intensive care to facilitate organ donation (ICOD) is a recently developed procedure involving life support for donation purposes. It has been scarcely studied, especially from the perspective of family members. This study thus investigated the views of families who have experienced donation through ICOD, aiming to identify and characterize the conditions influencing this process. Data were collected by interviewing 29 donor families recruited through seven Spanish hospitals. The systematic constant comparative method was employed for data analysis. Two routes to donation were found. The primary, and simple, route involves cases of high coherence between the patient’s positive will (expressed or inferred) about donation and decision-makers’ attitudes; it is more likely for expected loss. The secondary, more complex, route applies to cases in which unexpected loss or patient health trajectories predominate and several influential factors converge, such as expressions of doubt about the potential donor’s will, weaker family attitudes toward donation, slow and difficult deliberation, and a need for more support. The study enriches understanding of families’ decision-making process on donation and could inform psychosocial strategies to support their grieving process.