LAUSR

Until 2014 when controlled donation after circulatory death (cDCD) was reintroduced in Norway, it was only possible to fulfil the deceased's/family's desire for organ donation in cases where the lethal brain injury met the criteria for total cessation of brain circulation, donation after brain death (DBD). After reintroducing donation after circulatory death (DCD), many countries have focused on ethical concerns and issues regarding the criteria used to determine death and the need for guidelines [2,3,6,8,11,16,18,32]. Many healthcare professionals are concerned about how the next of kin experience DCD [4,10,16,24]. Most studies involving experiences around DCD are often limited to healthcare professionals [4,5,9,16,24]. Studies related to next of kin experiences are often limited to DBD [4,5,16,22,23,26,27,28] and more research on next of kin experiences with DCD is called for [6,12,17,18]. DCD can be performed both as uncontrolled (uDCD) and controlled (cDCD) with varying methods. Two review articles found that the general public's support for DCD was somewhat less or the same as for DBD [16,24]. Several articles that examined healthcare professionals concern with DCD are linked to end-of-life care and decision-making round withdrawal of life support [13,14,16]. One article described the use of the Palliative Care Team and argued that the team made a significant contribution both to the patient and to the family in the organ donation process, especially with DCD [17]. The authors argued for further research and experience in this area, and that national discussions are being conducted to refine this practice that will benefit the bereaved families in a difficult and challenging process [17]. Two studies that argued for specific donor oriented skills in care for relatives as important, recommended that major studies should be conducted to investigate families' need and their desire for support in the context of grief and donation, especially pertaining to the families who decline donation [21,29]. "The offer of organ donation should be a routine part of planning end of life" is one of the two main principles in the UK Donation Ethics