Abstract：
BACKGROUND: Tissue transplantation can improve the quality of life of patients in a very wide range of applications. In 2021, around 900 people in Germany agreed to donate organs after death - the number of tissue donors was significantly higher. Nevertheless, there is a shortage of organs and tissues in Germany. In order to counteract this, the introduction of a presumed consent legislation has been discussed time and again. However, the debates focused on possible positive effects for organ donation, whereas potential consequences for tissue donation have so far not been considered in the political discourse or in research. Using an exploratory approach, this paper aims to contribute to closing this research gap: Multidisciplinary interviews with experts were conducted to investigate whether the presumed consent legislation is a key success factor for increasing the number of tissue donors in Germany and which other approaches might be promising.
METHODS: We conducted qualitative interviews with 14 experts who worked as employees in different positions in tissue banks/networks, ophthalmologists performing corneal transplantation, medical ethicists, lawyers or scientists. These interviews were evaluated using the structuring content analysis according to Mayring. In reporting, we followed the Standards for Reporting Qualitative Research (SQRQ).
RESULTS: The majority of experts did not consider presumed consent legislation to be a key factor in increasing the donation rate in Germany. Instead, an improvement of processes and structures in tissue donation was cited as the most important optimization potential. Furthermore, communication measures were postulated to create transparency about the characteristics of tissue donation as distinct from organ donation. These should address not only the general population, but also the professional groups involved in the tissue donation process.
CONCLUSIONS: The present study indicates that the presumed consent legislation is not a success factor for increasing the number of tissue donors in Germany. It would be far more effective to improve structures and processes in order to identify the large number of potential tissue donors and to be able to conduct informed conversations with their relatives. Information measures for the general public and professionals, which clearly differentiate between tissue donation and organ donation, are also more promising than fruitless debates about the introduction of the presumed consent legislation.
METHODS: We conducted qualitative interviews with 14 experts who worked as employees in different positions in tissue banks/networks, ophthalmologists performing corneal transplantation, medical ethicists, lawyers or scientists. These interviews were evaluated using the structuring content analysis according to Mayring. In reporting, we followed the Standards for Reporting Qualitative Research (SQRQ).
RESULTS: The majority of experts did not consider presumed consent legislation to be a key factor in increasing the donation rate in Germany. Instead, an improvement of processes and structures in tissue donation was cited as the most important optimization potential. Furthermore, communication measures were postulated to create transparency about the characteristics of tissue donation as distinct from organ donation. These should address not only the general population, but also the professional groups involved in the tissue donation process.
CONCLUSIONS: The present study indicates that the presumed consent legislation is not a success factor for increasing the number of tissue donors in Germany. It would be far more effective to improve structures and processes in order to identify the large number of potential tissue donors and to be able to conduct informed conversations with their relatives. Information measures for the general public and professionals, which clearly differentiate between tissue donation and organ donation, are also more promising than fruitless debates about the introduction of the presumed consent legislation.
摘要：
背景：组织移植可以在非常广泛的应用中改善患者的生活质量。2021年，德国约有900人同意在死后捐献器官-组织捐献者的数量显着增加。然而，德国的器官和组织短缺。为了抵消这一点，一再讨论引入推定同意立法。然而,辩论的重点是器官捐赠可能产生的积极影响，而组织捐赠的潜在后果迄今尚未在政治话语或研究中考虑。使用探索性方法，本文旨在为缩小这一研究差距做出贡献:对专家进行了多学科访谈,以调查假定同意立法是否是德国组织捐献者数量增加的关键成功因素,以及其他哪些方法可能是有希望的.
方法：我们对14位在组织银行/网络中担任不同职位的员工的专家进行了定性访谈，眼科医生进行角膜移植，医学伦理学家,律师或科学家。根据Mayring，使用结构内容分析对这些访谈进行了评估。在报告中，我们遵循了定性研究报告标准(SQRQ)。
结果：大多数专家不认为假定同意立法是提高德国捐赠率的关键因素。相反，组织捐献过程和结构的改进被认为是最重要的优化潜力.此外，假设沟通措施可以提高组织捐献特征与器官捐献特征的透明度.这些不仅应该针对普通民众，还有参与组织捐赠过程的专业团体。
结论：本研究表明，假定的同意立法不是增加德国组织供体数量的成功因素。改善结构和流程以识别大量潜在的组织供体并能够与他们的亲属进行知情对话将更加有效。公众和专业人员的信息措施，明确区分组织捐赠和器官捐赠，也比关于引入推定同意立法的毫无结果的辩论更有希望。
方法：我们对14位在组织银行/网络中担任不同职位的员工的专家进行了定性访谈，眼科医生进行角膜移植，医学伦理学家,律师或科学家。根据Mayring，使用结构内容分析对这些访谈进行了评估。在报告中，我们遵循了定性研究报告标准(SQRQ)。
结果：大多数专家不认为假定同意立法是提高德国捐赠率的关键因素。相反，组织捐献过程和结构的改进被认为是最重要的优化潜力.此外，假设沟通措施可以提高组织捐献特征与器官捐献特征的透明度.这些不仅应该针对普通民众，还有参与组织捐赠过程的专业团体。
结论：本研究表明，假定的同意立法不是增加德国组织供体数量的成功因素。改善结构和流程以识别大量潜在的组织供体并能够与他们的亲属进行知情对话将更加有效。公众和专业人员的信息措施，明确区分组织捐赠和器官捐赠，也比关于引入推定同意立法的毫无结果的辩论更有希望。
