Willingness to donate: an interview study before liver transplantation
- 1Clinic for Internal Medicine and Psychosomatics, Charité, Humboldt-University Berlin, Berlin, Germany
- 2Department of Psychiatry, University of Basel, Basel, Switzerland
- 3Department of Psychosomatic Medicine and Psychotherapy, Otto-von-Guericke-University Hospital, Magdeburg, Germany
- Correspondence to: Dr M Walter Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse 27, CH- 4025 Basel, Switzerland; marc.walterpukbasel.ch
- Received 19 May 2003
- Accepted 7 August 2003
- Revised 30 June 2003
Abstract
Objectives: The introduction of the living donation in organ transplantation introduces important new psychological conflicts and ethical questions in the transplantation process. Operation related risks, as well as dependencies in the family structure, generate considerable pressure on potential donors. The aim of the study was to reconstruct the determinants of willingness to donate before transplantation.
Methods: Evaluation of 20 taped and transcribed interviews oriented to current approaches in qualitative interview research. The approach used is based on grounded theory, qualitative content analysis, and the concept of the ideal type.
Results: Before surgery, “openly motivated” donors push for an operation, leaving no room for ambivalence in the evaluation process. They idealise the relationship with the recipient, and link their donation with the individual—partly in subconscious expectations and wishes. In contrast, “openly ambivalent” donors formulate their anxieties and express arguments against donation.
Conclusions: Statements that claim ambivalence towards donation or utterance of arguments against donation indicate earlier coercion. Before transplantation, potential donors should have the opportunity to discuss their emotional situation to help their decision making process.
- living donor
- liver transplantation
- psychosocial evaluation
- qualitative research
- decision making
- communication
