title: Non-therapeutic intensive care for organ donation: A healthcare professionals' opinion survey.
abstract: OBJECTIVE
  Providing non-therapeutic intensive care for some patients in hopeless condition after cerebrovascular stroke in order to protect their organs for possible post-mortem organ donation after brain death is an effective but ethically tricky strategy to increase organ grafting. Finding out the feelings and opinion of the involved healthcare professionals and assessing the training needs before implementing such a strategy is critical to avoid backlash even in a presumed consent system.
  
  
  METHODS
  A single-centre opinion survey of healthcare professionals was conducted in 2013 in the potentially involved wards of a French University Hospital: the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Unit and the Emergency Department. A questionnaire with multiple-choice questions and one open-ended question was made available in the different wards between February and May 2013.
  
  
  METHODS
  The project was approved by the board of the Lorraine University Diploma in Medical Ethics.
  
  
  RESULTS
  Of a total of 340 healthcare professionals, 51% filled the form. Only 21.8% received a specific education on brain death, and only 18% on potential donor's family approach and support. Most healthcare professionals (93%) think that non-therapeutic intensive care is the continuity of patient's care. But more than 75% of respondents think that the advance patient's consent and the consent of the family must be obtained despite the presumed consent rule regarding post-mortem organ donation in France.
  
  
  CONCLUSIONS
  The acceptance by healthcare professionals of non-therapeutic intensive care for brain death organ donation seems fairly good, despite a suboptimal education regarding brain death, non-therapeutic intensive care and families' support. But they ask to require previously expressed patient's consent and family's approval. So, it seems that non-therapeutic intensive care should only remain an ethically sound mean of empowerment of organ donors and their families to make post-mortem donation happen as a full respect of individual autonomy.
authors.affiliation: University Hospital, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Camut
authors.affiliation: University Hospital, France; Ethos EA 7299, Université de Lorraine, France; Comité de Réflexion Ethique Nancéien Hospitalo-Universitaire, France a.baumann@chu-nancy.fr.
authors.forename: Antoine
authors.initials: A
authors.lastname: Baumann
authors.affiliation: University Hospital, France; Comité de Réflexion Ethique Nancéien Hospitalo-Universitaire, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Dubois
authors.affiliation: University Hospital, France; Ethos, EA 7299, Université de Lorraine, France; Comité de Réflexion Ethique Nancéien Hospitalo-Universitaire, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Ducrocq
authors.affiliation: University Hospital, France; Comité de Réflexion Ethique Nancéien Hospitalo-Universitaire, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Audibert
mesh_terms: D001291:Attitude of Health Personnel; D001926:Brain Death; D003422:Critical Care / Q000941:ethics*; D005602:France; D006785:Hospitals, University; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D020380:Needs Assessment; D009728:Nursing Assistants / Q000523:psychology* / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D019724:Presumed Consent / Q000941:ethics; D011368:Professional-Family Relations; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement
keywords: Elective ventilation; ethics; non-therapeutic care; nursing; organ donation; presumed consent