University of São Paulo at Ribeirão Preto College of Nursing, Brazil.
Nurs Ethics. 2019 Sep;26(6):1886-1896. doi: 10.1177/0969733018791335. Epub 2018 Aug 22.
Organ donation and transplantation represent one of the most important scientific advances over the last decades. Due to the complexity of these procedures and related ethical-legal aspects, however, there are a lot of doubts and uncertainty about the brain death diagnosis and the maintenance of potential organ donor.
To identify and discuss the different meanings and experiences of registered nurses and physicians from an adult intensive care unit in relation to the diagnosis of brain death and the maintenance of potential organ donors for transplantation purposes.
Participants were registered nurses and physicians from an adult intensive care unit at a University Hospital from Brazil. Data were collected through semi-structured interviews and analyzed using content analysis.
This study was approved by the University of São Paulo at Ribeirão Preto College of Nursing Research Ethics Committee.
Two main categories emerged from the analysis: (1) brain death diagnosis and its implications and (2) maintenance of the potential organ donor and its repercussion in the donation-transplantation process. Six subcategories were also identified: (1.1) understanding the brain death diagnosis as a tool to aid decision-making; (1.2) diagnosis as guarantee of rights; (1.3) difficulties encountered to establish the diagnosis; (1.4) clinical criteria adopted in Brazil and related ethical-legal aspects; (2.1) specificities of care to the brain dead person and outcomes; and (2.2) nurse's duties toward the brain dead person.
Although the brain death diagnosis is scientifically and legally defined in Brazil and the maintenance of the potential organ donor for transplantation purposes has been addressed during the last years, there are still some doubts about the subject, as its understanding varies according to the personal beliefs, culture, and educational background of individuals, including those who work in this scenario.
器官捐献和移植是过去几十年中最重要的科学进步之一。然而，由于这些程序的复杂性以及相关的伦理法律方面，人们对脑死亡诊断和潜在器官捐献者的维持存在很多疑问和不确定性。
确定并讨论来自巴西某大学附属医院成人重症监护病房的注册护士和医生对脑死亡诊断和维持潜在器官捐献者以进行移植的不同看法和体验。
参与者为来自巴西某大学附属医院成人重症监护病房的注册护士和医生。通过半结构化访谈收集数据，并使用内容分析法进行分析。
本研究得到了圣保罗大学里贝朗普雷托护理学院伦理委员会的批准。
从分析中得出两个主要类别：（1）脑死亡诊断及其影响，（2）潜在器官捐献者的维持及其对捐献-移植过程的影响。还确定了六个子类别：（1.1）将脑死亡诊断理解为辅助决策的工具；（1.2）诊断作为权利保障；（1.3）在确定诊断时遇到的困难；（1.4）巴西采用的临床标准和相关伦理法律方面；（2.1）对脑死亡患者的特殊护理和结果；（2.2）护士对脑死亡患者的职责。
尽管脑死亡诊断在巴西从科学和法律上都有定义，并且近年来已经解决了潜在器官捐献者的维持问题，但对于这个主题仍然存在一些疑问，因为对其的理解因人而异，取决于个人的信仰、文化和教育背景，包括那些在这种情况下工作的人。
