2. Disclosure belangen NHG spreker
(Potentiële) belangenverstrengeling
Geen
Voor bijeenkomst mogelijk relevante relaties met bedrijven
Sponsoring of onderzoeksgeld
Honorarium of andere (financiële) vergoeding
Aandeelhouder
Andere relatie, namelijk …
NTS paid expenses

3. Organ donation after euthanasia and the GP
Han Mulder, MD PhD GP

4. The essence of ODE ODE Organ donation after euthanasia
ODET Organ donation after euthanasia from home

5. Han Mulder, Landelijke Huisartsen Vereniging
Peter wil organen kunnen doneren
Han Mulder, Landelijke Huisartsen Vereniging

6. Introduction
Patients are requesting organ donation after euthanasia (ODE)
Current practice, which developed spontaneously, raised ethical, legal and social issues
A guideline was prepared focusing on the situation of a patient in the final phase of his life with the involvement of a GP

7. Research question
What experience do GPs have with ODE and what questions do they have about it?

8. Methodology
Healthcare professionals, patient organisations and relatives of now deceased ODE patients were involved
One element of this were semi-structured interviews with GPs, with and without experience of ODE

9. Methodology Semi-structured interview
Qualitative or in-depth interviews with interview schedule with questions with general and closed formulation, further questioning for detailed information
Received flow chart and patient information

10. Methodology Construct validity Internal validity External validity
Precise question formulation with testing of whether this produced the answer we sought
Internal validity
Fixed interview schedule with open and closed questions, attempting to evaluate different aspects of experience
External validity
Aselect group of GPs, however group with experience limited, without experience via call to participate. Generalizability of sample.
Ecological validity
Familiar home environment

11. Methodology Structured interview Semi-structured interview
Unstructured interview
Focus group
Construct validity
Yes No
External validity
Internal validity
Ecological validity

12. Results Interviews with eight GPs with experience of ODE
ODE experience between
Interviews with ten GPs without experience of ODE
2016, eastern region of the Netherlands through doctors organisation

13. With experience Main difficulties identified:
Time taken by procedure in hospital
Determining death
Who decides what
Differing legal agreements with the hospitals

14. With experience Expressed a need for good training courses
Had mixed feelings about presence of donation staff and other unfamiliar healthcare professionals, as well as about the impact on the patient and family being greater than expected

15. Without experience
Main difficulties identified:
Death in the hospital setting and the burden this places on the patient and family
The degree to which this can be explained

16. Without experience
Main difficulties
Also foresaw problems in relation to the intimacy of the end of life care and bringing the topic up for discussion
Indicated that it was important for adequate information to be provided to patients, family and GPs, for example via thuisarts.nl.

17. Conclusion
GPs with experience of ODE mainly had questions about uncertainties during the procedures whereas GPs without experience were mainly concerned about how the euthanasia process would be experienced. Follow-up research seems advisable.

18. Guideline ‘Organ donation after euthanasia’ NTVG Guideline December 2017