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Parental Experiences and Recommendations in Donation After Circulatory Determination of Death*

Hoover, Stephanie M. PhD1; Bratton, Susan L. MD, MPH2; Roach, Elizabeth RN, BSN3; Olson, Lenora M. PhD2

Pediatric Critical Care Medicine: February 2014 - Volume 15 - Issue 2 - p 105–111
doi: 10.1097/PCC.0000000000000035
Feature Articles

Objective: To describe parents’ experience of organ donation decision making in the case of donation after circulatory determination of death.

Design: Qualitative exploratory analysis.

Setting: Participants were recruited from the ICU of a single children’s hospital located in the western United States.

Participants: Thirteen parents, 11 families who consented to donate their child’s organs.

Interventions: Interviews (average 82 min).

Measurements and Main Results: Transcribed interviews were analyzed using the constant comparative method to identify themes that reflected similarities in parents’ experiences. The themes we found included 1) factors contributing to parental decision making, 2) under the circumstances of the child dying, and 3) donation decision and its impact on parental grief. Factors that influenced the decision making all related to the child dying, including protecting the child’s body and helping the child to die peacefully. Finally, parents made recommendations about the organ donation process, including empathy, attend to end-of-life concerns, and the provision of relevant information for donation decisions.

Conclusions: Parents’ decision making was related directly to end-of-life experience and grief process. Providers need to orient to parents’ end-of-life concerns to support parents’ decision-making process and improve donation after circulatory determination of death procedures.

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1Department of Educational Psychology, University of Utah, Salt Lake City, UT.

2Department of Pediatrics, University of Utah, Salt Lake City, UT.

3Pittsburgh, PA.

* See also p. 171.

Current address for Dr. Hoover: Department of Psychology, Western Oregon University, Monmouth, OR.

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 (

Supported, in part, by the Dialysis Research Foundation, Ogden, UT.

Dr. Bratton received grant support from the Dialysis Research Foundation and received support for travel to the European Pediatric Academic Society Meeting 2012. Dr. Hoover consulted for, received support for travel from, and received support for manuscript writing/review (paid as part of consulting fee) from the Department of Pediatrics, University of Utah.

Dr. Roach received grant support from the Dialysis Research Foundation.

Dr. Olson received grant support from the University of Utah.

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©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies