SPECIAL OPINION: Edited by Linda S. Sher‘As a surgeon, I am obliged to every single patient’: evaluation of focus group discussions with transplantation physicians on the allocation of donor organsBartling, Tima,b; Oedingen, Carinaa,b; Schrem, Haraldb,c,d; Kohlmann, Thomase; Krauth, Christiana,bAuthor Information aInstitute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School bCenter for Health Economic Research Hannover (CHERH), Hannover, Germany cTransplant Center Graz dDepartment of Transplant Surgery, Medical University Graz, Graz, Austria eDepartment for Methods of Community Medicine, Institute for Community Medicine, University of Greifswald, Greifswald, Germany Correspondence to Tim Bartling, MSc, Medizinische Hochschule Hannover/Hannover Medical School Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Tel: +49 511 532 9462; e-mail: [email protected] Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-transplantation.com). Current Opinion in Organ Transplantation: October 2021 - Volume 26 - Issue 5 - p 459-467 doi: 10.1097/MOT.0000000000000908 Buy SDC Metrics Abstract Introduction Organ transplantation is the last resort for many patients. The ubiquitous shortage of suitable donor organs raises the question of best-justifiable allocation worldwide. This study investigates how physicians would allocate donor organs. Methods Focus group discussions with a total of 12 transplant surgeons and 2 other transplant-related physicians were held at the annual conference of the German Transplantation Society (Oct 2019). Three groups discussed aspects of ‘egalitarianism’, ‘effectiveness/benefit’, ‘medical urgency’, ‘own fault’, ‘medical background’ and ‘socio-demographic status’. Results and Discussion It was observed that physicians often find themselves confronted with conflicts between (a) trying to advocate for their individual patients versus (b) seeing the systemic perspective and understanding the global impact of their decisions at the same time. The groups agreed that due to the current shortage of donor organs in the German allocation system, transplanted patients are often too sick at the point of transplantation and that a better balance between urgency and effectiveness is needed. The aspects of ‘effectiveness’ and ‘urgency’ were identified as the most challenging issues and thus were the main focus of debate. The dilemmas physicians find themselves in become increasingly severe, the larger the shortage of suitable donor organs is. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.