Introduction: Lack of consent is one of the main barriers for organ donation. An opt-in registration on the Organ Donor Register (ODR) is a first person consent to donate. Nevertheless, in the UK, those close to the patient are involved in discussions and can ultimately override an ODR registration. Minority Ethnic (ME) groups contribute to less than 10% of the total ODR opt in registrations. In 2021-2022, three out of the 68 opt in ODR overrides in the UK were from ME families. Consent rate in the UK is 68% and although organ donation is permissible within the Islamic faith, consent for organ donation amongst this faith group is 80% lower than other faiths (NHSBT, 2021). Following the US model, the role of the Specialist Requestor (SR) was implemented in the UK in 2015 as a way to optimise consent rates for organ donation. It was believed that if a subgroup of Specialist Nurses (SNs) were responsible for all the approaches for organ donation they would have a greater exposure and become highly skilled in these conversations. There is no statistically significant data to suggest that consent rates are higher amongst SRs when compared to SNs. Nevertheless, SRs have a larger exposure and thus greater experience to approaching ME families (McLaughin et al; 2021)
Method: Case study
Results: This case study examines the role of the SR supporting a Turkish Muslim family who wanted to override their loved one’s opt-in registration on the ODR. This case was complicated by the inability to communicate face to face with the family, language barriers and limited knowledge of the Islamic beliefs and rituals surrounding death. This involved an open dialogue with the family by telephone and video calls with the aid of a translator for several hours and the invaluable support from an Imam.
Conclusion: The use of an independent interpreter is considered best practice to ensure that the medical language is communicated effectively by a professional, who is neutral and emotionally removed from the situation. The use of video conferencing has the benefit of picking up non-verbal cues from a family. Nevertheless, it has its limitations over face to face communication. Religion and culture influence the views of people towards organ donation. SRs have potentially the benefit of an increased knowledge of the different views and attitudes of ME communities towards organ donation as well as religious and cultural end-of-life rituals. The involvement of a faith leader was key and it is recommended as routine practice to support end-of-life care and clarify any religious queries (Khan, 2021). A thorough planning discussion is required to ensure that the Imam can support such practices and to assess their potential involvement in organ donation discussions. Further engagement with ME communities to understand perspectives on organ donation is also advised.