title: Fear, ambivalence, and liminality: key concepts in refusal to donate an organ after brain death.
abstract: The refusal to donate an organ is a phenomenon in need of exploration and explanation. This article refers to the major fear of becoming an organ donor in relation to a global culture perspective and to the Halacha (Jewish law). A theoretical critique about the ambivalence demonstrated by health care providers and families will discuss these concepts in relation to brain death, from the stages of hospitalization, through the period prior to the assertion of brain death, ending with brain death, and its perspective as a liminal situation.Finally, we conclude that nursing practices during the care of the "brain dead" patient, and toward the patient's family, should convey an unequivocal message. That is, brain death describes irreversible cessation of all brain function, and therefore, the patient becomes a dead body and can be treated as a potential organ donor.
authors.affiliation: Nursing Research Unit, Assaf Harofe Medical Center, Be'er-Yaakov, Israel. rasinm@asaf.health.gov.il
authors.forename: Michal
authors.initials: M
authors.lastname: Rassin
authors.forename: Miri
authors.initials: M
authors.lastname: Lowenthal
authors.forename: Dina
authors.initials: D
authors.lastname: Silner
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001294:Attitude to Health; D001926:Brain Death / Q000175:diagnosis* / Q000331:legislation & jurisprudence; D003220:Conflict, Psychological; D005190:Family / Q000523:psychology; D005239:Fear / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D007585:Jews / Q000193:education / Q000331:legislation & jurisprudence / Q000523:psychology; D007599:Judaism / Q000523:psychology*; D008020:Life Support Care / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D010353:Patient Education as Topic; D011368:Professional-Family Relations; D045808:Refusal to Participate / Q000331:legislation & jurisprudence / Q000523:psychology*; D020458:Third-Party Consent; D013997:Time Factors; D014019:Tissue Donors / Q000331:legislation & jurisprudence / Q000523:psychology*; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence