Socio-cultural Aspects of Death and Post-mortem Organ Donation Behaviours

Glavni raziskovalni interes doktorske disertacije je bil usmerjen v raziskovanje razmerja med širšimi družbeno-kulturnimi vidiki smrti in vedenji pri darovanju organov po smrti (ta so: opredelitev odločitve v registru darovalcev, pogovor o odločitvi z bližnjimi in privolitev v darovanje organov umrlih svojcev). K vprašanju darovanja organov po smrti se pristopa z vidika smrti, ki je podraziskan kot vpliv na vedenja pri darovanju organov po smrti. Za raziskovanje je bil uporabljen kvalitativni eksploratorni raziskovalni načrt. Glavni raziskovalni metodi sta bili sekundarna analiza virov in polstrukturirani poglobljeni intervjuji. Primarna raziskava je bila izvedena v Sloveniji na heterogenem vzorcu 17 oseb z raznolikim demografskim ozadjem, ki odločitve o darovanju organov po smrti niso formalno opredelile. Podatki so bili analizirani z refleksivno tematsko analizo. Ugotovitve so razkrile visoko javno podporo in pripravljenost za darovanje organov po smrti, ko je bil premislek o odločitvi vezan na utilizacijo trupel kot načina omogočanja življenja tistim, ki se borijo za preživetje zaradi odpovedi organov. Ko je bil premislek o odločitvi vezan na razmislek o smrti, je bil zaznamovan z ambivalentnostmi in negotovostmi. Ugotovitve kažejo tudi, da dejavniki, ki inhibirajo vedenja pri darovanju organov po smrti, nakazujejo na onesnaženje procesa smrti, kar pomeni, da oseba ni zmožna integrirati ideje o darovanju organov po smrti v svoje osebno razumevanje smrti. Poleg tega sprejemanje smrti nakazuje na jasnejšo (ne)pripravljenost za darovanje organov po smrti, medtem ko strah ali tesnoba pred smrtjo nakazuje na ambivalenten odnos do te odločitve ob koncu življenja zase in za druge. Najpomembnejši prispevek k znanosti predstavlja razvit konceptualni okvir, ki raziskovalcem omogoča opazovati medsebojno delovanje širšega sociokulturnega konteksta in individualnega odločanja o koncu življenja. Doktorska disertacija je prva, ki poglobljeno raziskuje deljeno družbeno realnost smrti v Sloveniji in zato s svojimi ugotovitvami prinaša pomemben empirični doprinos.This doctoral dissertation explored the relationship between broad socio-cultural aspects of death and individual post-mortem organ donation behaviours (i.e., the decision to register, discussing the decision with significant others and consenting to the organ donation of next of kin). It approached the question of post-mortem organ donation from the perspective of death, whose influence on post-mortem organ donation behaviour has received little research attention. The study employed a qualitative exploratory research design, with secondary data analysis and semi-structured in-depth interviews as the main research methods. The primary study was implemented in Slovenia through a purposive heterogeneous sample of 17 people of varying demographic backgrounds who did not formally declare a decision regarding post-mortem organ donation. The data were analysed using reflexive thematic analysis. The findings revealed high public support and an initial willingness towards post-mortem organ donation as a way to utilise dead bodies to prolong the lives of organ failure patients. When post-mortem organ donation was considered a plausible end-of-life decision from the standpoint of death, it became imbued with ambivalence and uncertainty. The findings also pointed to inhibitory factors as indications of the pollution of the death process, meaning that a person is unable to integrate the idea of post-mortem organ donation in their personal understanding of death. Furthermore, death acceptance provided clearer indications of (un)willingness towards post-mortem organ donation, whereas fear of death or death anxiety indicated ambivalence towards this end-of-life decision for oneself or significant others. The most important contribution to the scientific field is the conceptual framework developed to enable researchers to observe the interplay between the wider socio-cultural context and individual end-of-life decision-making. Furthermore, as the first comprehensive study of the shared social reality of death in Slovenia, the dissertation also makes important empirical contributions