General practitioners’ perspectives on organ donation after euthanasia: a qualitative exploratory questionnaire study

Family Practice, vol. 43

Abstract

BACKGROUND: General practitioners (GPs) play a crucial role in organ donation after euthanasia (ODE). This study explores their knowledge and perspectives regarding medical, ethical, and logistical aspects of ODE to improve patient-centred care and existing guidelines. METHODS: An exploratory study was conducted among Dutch GPs using an expert-validated online questionnaire covering awareness, experiences, barriers, and ethical considerations. Quantitative data were analysed descriptively; qualitative data underwent thematic analysis, following Standards for Reporting Qualitative Research. RESULTS: Fifty-two GPs participated. Of these, 78% (n = 38) were aware of ODE, 97% (n = 48) had a positive or neutral stance towards ODE, and 31% (n = 15) were familiar with national guidelines. Five themes emerged: (i) patient autonomy and decision-making; (ii) communication and information; (iii) logistical organization; (iv) impact and barriers; and (v) ethical debates. Patient autonomy was reported as central throughout the ODE process, particularly during decision-making and the final phase. Ninety per cent (n = 48) of the GPs preferred assessing whether discussing ODE within that patient's context was appropriate. GPs varied in opinion regarding the preferred timing for discussing ODE: 42% (n = 25) would introduce it during general end-of-life discussions, 27% (n = 16) would wait for the formal euthanasia request, and 17% (n = 10) would choose a patient-tailored moment. GPs expressed concerns regarding extra workload and emotional impact, with 52% (n = 24) hesitant to initiate ODE for these reasons. CONCLUSION: GPs play a central role in ODE, applying flexible, patient-tailored approaches supporting patient autonomy. Redistribution of tasks by early organ donation coordinator involvement, improved guidelines, and clear patient information could improve ODE care in Dutch general practice.

Authors 9

1. Nathalie van Dijk corresponding

   Maastricht University Medical Centre

   Affiliation as printed

   Department of Intensive Care Medicine, Maastricht Medical Center+ , Maastricht 6229HX ,

2. Suzie Krebbekx

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Department of Intensive Care Medicine, Maastricht Medical Center+ , Maastricht 6229HX ,

   Faculty of Health, Medicine and Lifesciences, Maastricht University , Maastricht 6229ER ,

3. Wim de Jongh

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Heart and Vascular Centre, Maastricht University Medical Center+ , Maastricht 6229HX ,

4. Tineke Jentina Wind

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Heart and Vascular Centre, Maastricht University Medical Center+ , Maastricht 6229HX ,

5. Mattijs Everard Numans Aachen

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Gezondheidscentrum Oog in Al , Utrecht 3533GH ,

   Health Campus Den Haag , the Hague 2511DP ,

   Leiden University Medical Centre , Leiden 2333ZG ,

6. Jeroen Smeets

   Maastricht University

   Affiliation as printed

   Department of Family Medicine, Maastricht University , Maastricht 6229HA ,

7. Daan Verbruggen

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Department of Intensive Care Medicine, Maastricht Medical Center+ , Maastricht 6229HX ,

   Faculty of Health, Medicine and Lifesciences, Maastricht University , Maastricht 6229ER ,

8. Jan A.M. Bollen

   Radboud University Nijmegen · Radboud University Medical Center

   Affiliation as printed

   Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center , Nijmegen 6525GA ,

9. Walther van Mook

   Maastricht University Medical Centre · Maastricht University

   Affiliation as printed

   Academy for Postgraduate Medical Training, Maastricht University Medical Centre+ , Maastricht 6229HX ,

   Department of Intensive Care Medicine, Maastricht Medical Center+ , Maastricht 6229HX ,

   School of Health Professions Education, Maastricht University , Maastricht 6229ER ,