Views of admitted palliative care patients and their clinicians on corneal donation discussions differ: A qualitative content analysis of semi-structured interviews

Abstract

Abstract Background Blindness from corneal opacity accounts for 2.4% of cases of blindness worldwide. There is a severe shortage of corneas for donation, globally, for transplantation and research purposes. One group of individuals who could potentially be donors are those who die within the inpatient palliative care unit. The aim of the study was to understand clinician and patient perceptions of discussing corneal donation in palliative care units. Methods A qualitative design was utilised with data collected through semi-structured interviews. A total of 46 interviews were undertaken involving inpatient palliative care unit patients (19) and clinicians (27) in three major inpatient palliative care units in South Australia. Results Very few patient participants reported being asked about corneal donations during their time in palliative care. Most inpatient palliative care unit clinicians did not raise the topic as they felt other areas of care took precedence. Inpatient palliative care unit patients thought if inpatient palliative care unit clinicians did not raise the topic, then it was not important. There were some differences between patient and clinician views, such as preference about who raises the possibility of donation and when the discussion might occur. Conclusions Findings suggest that patients are receptive to discussing corneal donations, but clinicians are not initiating these. This is a missed opportunity for donors and potential recipients. We recommend that clinicians routinely consider discussing organ donation as part of palliative care.