Bakgrund: Organtransplantation är en livräddande behandling vid terminal organsvikt men det råder en global brist på potentiella organdonatorer. Sjuksköterskan har en viktig roll i att öka medvetenheten om organdonation i samhället och hennes attityd till och kunskap om organdonation kan påverka människors beslut att donera. Syfte: Syftet med studien var att undersöka vilka faktorer som påverkar sjuksköterskans attityd till organdonation. Metod: Studien genomfördes som en allmän litteraturstudie där 15 vetenskapliga artiklar från tre olika databaser granskades och analyserades. Resultat:Analysen resulterade i fem kategorier: Kunskapens påverkan, Arbetslivserfarenhetens påverkan, Familjen och den egna donationsviljans inflytande, Religionens inflytande och Misstro mot hälso- och sjukvården och lagstiftningen. Konklusion: Kunskap om kriterier för att fastställa död, organdonation, donationsprocessen och kommunikationsmetoder hjälpte sjuksköterskorna att förmedla adekvat information. Att vårda potentiella organdonatorer skapade en emotionell stress och att lyfta frågan om donation med donatorns familj var påfrestande. Att ha diskuterat organdonation inom den egna familjen var gynnsamt för attityden. Sjuksköterskans egen tolkning av sin religions inställning till organdonation påverkade attityden. Sjuksköterskorna upplevde rädsla för att gå miste om återupplivningsåtgärder eller att dödförklaras för tidigt som registrerade organdonatorer. / Background: Organ transplantation is a life-saving treatment but there is a global shortage of potential organ donors. The nurse has an important role in increasing awareness of organ donation. Her attitude toward and knowledge about organ donation might influence people’s decision to donate. Aim: The aim was to investigate factors that influence the nurse’s attitude toward organ donation. Method: This study was carried out as a general literature study. Fifteen scientific articles from three different data bases were reviewed and analyzed. Result: The analyze resulted in five categories: The impact of knowledge, The impact of work experience, The impact of family and own willingness to donate, The influence of religion and Distrust in the health care system and legislation. Conclusion: Knowledge about death criteria, organ donation and communication skills helped the nurse’s to convey information. Caring for potential organ donors generated an emotional stress and raising the question about donation with donor families was stressful. Having discussed organ donation within the own family was favorable for the attitude. The nurse’s own interpretation of her religion’s attitude toward organ donation influenced the attitude. The nurses experienced fear of not receiving proper resuscitation of being declared dead prematurely as registered organ donors.

Over the last few years, policies have been introduced in the UK which aim to improve organ transplantation rates by changing the way that potential organ donors are treated before death. Patients incapacitated due to catastrophic brain injury may now undergo ante-mortem donor optimisation procedures to facilitate deceased organ donation. As I identify in this thesis, the most significant ethical and legal problem with these policies is that they are not based on what the patient would have chosen for themselves in the specific circumstances. The policies identify and treat patients meeting certain clinical criteria as a group rather than the individuals, with their own viewpoints, that the law on best interests requires. They equate registration on the Organ Donation Register with ante-mortem donor optimisation procedures being in their best interests, despite registrants having neither been informed about nor given consent to ante-mortem interventions. The overarching claim I make in this thesis is that a system of specific advance consent is needed to provide a clear and unequivocal legal justification for ante-mortem donor optimisation procedures. The ethical foundation for this claim is autonomy, and this is the central theme running through all six chapters. I argue that autonomy should be incorporated into donor optimisation policy to promote the dignity and integrity of potential organ donors and to safeguard trust in the organ donation programme. I argue that a system of specific advance consent is needed as part of the duty of care owed to registrants on the Organ Donor Register and to facilitate the determination of the best interests of the potential organ donor. I argue that the state has not established the necessity of the current policy of non-consensual donor optimisation procedures and that they are under an ethical and legal obligation to introduce an autonomy-based framework for ante-mortem interventions to facilitate organ donation.