Hope for a peaceful death and organ donation

The therapeutic, social and economic benefits of organ transplantation are irrefutable; however, organ shortages contribute to avoidable patient deaths and burgeoning health care costs. This problem can be addressed by increasing family consent to deceased organ donation. There are high levels of community support for deceased organ donation in Australia and yet, almost fifty percent of families decline the request to donate. Increasing the number of families who agree to deceased organ donation is key to increasing national and international transplantation rates. The purpose of this study was to identify the major factors that influence a family to agree or decline deceased organ donation during the process of decision-making. The aims of the study were three-fold: to identify the key stages and the major influencers’ in the decisionmaking process; to determine if hope, deep hope and trust played a role in the decision, and to explore families’ perceptions of their decision-making experience. The study utilised an exploratory case study approach to examine the family decisionmaking process of deceased organ donation. Following ethics approval, recruitment was conducted utilising a qualitative purposive snowball strategy across Australia. A pilot study was conducted to test the study procedures prior to the main data collection, and 22 participants who had been involved in a deceased organ donation decision from nine families were interviewed. In five deaths family members had agreed to organ donation, and in four deaths the family declined. A theoretical framework based on the Precaution Adoption Process Model of decision-making was applied to propose trust, hope and deep hope underpin family organ donation decisions. Thematic analysis was conducted and three key themes comprising ‘In the fog drowning’, ‘Harvesting humanity’, and ‘It’s all up to Mum’ were revealed. The study found women, and in particular mothers, played a significant role in organ donation decision-making, and that the decision-making is bounded by family needs of trust, hope and deep hope across the continuum of time. It also found families who had their trust, hope and deep hope needs met expressed satisfaction about their decision-making experience and agreed to organ donation. Some families perceived that organ donation was a sacrifice that was too great to endure, even if the deceased had previously indicated intent to donate, and therefore declined donation. This study found that families’ ideas of a peaceful death and organ donation are not mutually exclusive. It concludes that when decision-makers’ trust and deep hope needs are met they are more willing to agree to donation. This study recommends that the idea of a ‘right’ to a peaceful death should be aligned with deceased organ donation practices and normalised.

A critical and interpretative investigation of the ethical dimension of policies about school digital technologies

This thesis examines digital technologies policies designed for Australian schools and the ways they are understood and interpreted by students, school staff, teachers, principals and policy writers. This study explores the ways these research participant groups interpret and understand the ‘ethical dimension’ of schools’ digital technologies policies for teaching and learning. In this thesis the ethical dimension is considered to be a dynamic concept which encompasses various elements including; decisions, actions, values, issues, debates, education, discourses, and notions of right and wrong, in relation to ethics and uses of digital technologies in schools. In this study policy is taken to mean not only written texts but discursive processes, policy documents including national declarations, strategic plans and ‘acceptable use’ policies to guide the use of digital technologies in schools. The research is situated in the context of changes that have occurred in Australia and internationally over the last decade that have seen a greater focus on the access to and use of digital technologies in schools. In Australian school education, the attention placed on digital technologies in schools has seen the release of policies at the national, state, territory, education office and school levels, to guide their use. Prominent among these policies has been the Digital Education Revolution policy, launched in 2007 and concluded in 2013. This research aims to answers the question: What does an investigation reveal about understandings of the ethical dimension of digital technologies policies and their implementation in school education? The objective of this research is to examine the ethical dimension of digital technologies policies and to interpret and understand the responses of the research participants to the issues, silences, discourses and language, which characterise this dimension. In doing so, it is intended that the research can allow the participants to have a voice that, may be different to the official discourses located in digital technologies policies. The thesis takes a critical and interpretative approach to policies and examines the role of digital technologies policies as discourse. Interpretative theory is utilised as it provides a conceptual lens from which to interpret different perspectives and the implications of these in the construction of meaning in relation to schools’ digital technologies policies. Critical theory is used in tandem with interpretative theory as it represents a conceptual basis from which to critique and question underlying assumptions and discourses that are associated with the ethical dimension of schools’ digital technologies policies. The research methods used are semi-structured interviews and policy document analysis. Policies from the national, state, territory, education office and school level were analysed and contribute to understanding the way the ethical dimension of digital technologies policies is represented as a discourse. Students, school staff, teachers, principals and policy writers participated in research interviews and their views and perspectives were canvassed in relation to the ethical use of digital technologies and the policies that are designed to regulate their use. The thesis presents an argument that the ethical dimension of schools’ digital technologies policies and use is an under-researched area, and there are gaps in understanding and knowledge in the literature which remain to be addressed. It is envisaged that the thesis can make a meaningful contribution to understand the ways in which schools’ digital technologies policies are understood in school contexts. It is also envisaged that the findings from the research can inform policy development by analysing the voices and views of those in schools. The findings of the policy analysis revealed that there is little attention given to the ethical dimension in digital technologies at the national level. A discourse of compliance and control pervades digital technologies policies from the state, education office and school levels, which reduces ethical considerations to technical, legal and regulatory requirements. The discourse is largely instrumentalist and neglects the educative dimension of digital technologies which has the capacity to engender their ethical use. The findings from the interview conversations revealed that students, school staff and teachers perceive digital technologies policies to be difficult to understand, and not relevant to their situation and needs. They also expressed a desire to have greater consultation and participation in the formation and enactment of digital technologies policies, and they believe they are marginalised from these processes in their schools. Arising from the analysis of the policies and interview conversations, an argument is presented that in the light of the prominent role played by digital technologies and their potential for enhancing all aspects of school education, more research is required to provide a more holistic and richer understanding of the policies that are constructed to control and mediate their use.