Correlates of willingness to consider organ donation among blacks

Professionals in the health care and organ procurement fields reveal that black Americans display limited commitment to organ donation. The present study represents an attempt to shed some light on this issue by examining the relationship of selected demographic, knowledge and attitude-belief variables to willingness to consider organ donation within a black population. Findings indicated that only a few of the demographic and knowledge variables were related to willingness to consider organ donation. All of the attitude-belief variables, however, were found to be significantly associated with the dependent variable. Implications of the findings for recruiting black organ donors and future research are discussed.     

自愿捐赠移植器官知情同意权问题的探讨

自从人体器官移植技术开展以来，器官捐赠已经成为器官来源的最重要的途径和方式。随着这项技术的广泛开展，规范了器官捐赠行为，使器官捐赠者的自主权得到有效合法保护，捐赠者的知情权和同意权得到全面履行，从而提高捐赠者参与社会捐赠的积极性，以便解决器官需求紧缺状况。     

Gender dynamics in the donation field: human tissue donation for research,therapy and feeding

This paper examines how gender dynamics shape human tissue donation for research and for human health. Drawing on research investigating the donation of different types of bodily tissues including blood, plasma, breastmilk, cord blood, foetal tissue and placentae we consider how and why women and men are viewed as different kinds of donors. We situate these donation practices within a broader understanding of gender difference to explain why any sociology of donation needs to take account of gender. In so doing we explore how tissue derived from the bodies of women acquires value in distinctive ways and for distinctive purposes and reasons. Within these gendered bioeconomies of donation, the supply and demand for tissue is structured by social understandings of maternity, parental responsibility, and risk, which in turn affect the experiences of donors.     

Egg donation for stem cell research: ideas of surplus and deficit in Australian IVF patients' and reproductive donors' accounts

We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients' and reproductive donors' perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes' fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents' much greater willingness to donate frozen embryos for human embryonic stem cells research.     

Are ‘anonymous’ and ‘non-directed’ prerequisites for living altruistic donation? The views of transplant physicians from France and Québec

It can be argued that living altruistic donors should remain anonymous and should not express preferences in the selection of organ recipients. This study aimed to describe the views of transplant physicians in France and Québec regarding these issues. A total of 27 French and 19 Québec renal transplant physicians took part in individual, semi-directed interviews. Almost all of the physicians agreed that anonymity is mandatory in living altruistic donation (LAD). Regarding the issue of directed donation, most of the French physicians (78%) were opposed to any form of the practice, compared to only a third of their Québec colleagues (32%). We found that these positions were embedded in their respective cultural, legal and social contexts. These results afford a better understanding of these complex issues in two different cultural contexts, and will be useful in the development of international guidelines for LAD.     

社会募捐现状及意向调查——以上海宝山区为例

目的了解目前公益募捐的特点、公众意向和存在问题,更好地发展社会公益事业。方法对宝山区社会各界266人进行问卷调查,组织公益性社会团体座谈。对社会各界募捐参与情况、募捐动机及捐款用途知晓度等方面进行调查、分类统计和比较。结果本研究表明,公益募捐在救灾、扶贫、助学及资助公益事业方面发挥了很大作用。社会各界意向调查结果显示,公益募捐应以社团为主;政府部门应创造良好的制度保证和社会氛围。募捐组织工作应淡化行政色彩、不予摊派。结论公益社团应加强自身管理、增加操作程序和募捐款去向的透明度,做好政府助手,不断推动公益募捐事业发展。     

Organ transplantation. Speed and deliberation raise questions of trust

A double whammy of organ transplant stories hit the media within days of one another, giving the public plenty to mull over. Overall, the media's treatment seemed well-balanced. It sifted through the details of Mickey Mantle's speedy transplant of a new liver and declared the former slugger's shot for a new liver to be fair. On the other hand, the media called foul the latest report by the AMA Council on Ethical and Judicial Affairs (CEJA), which recommends the use of anencephalic neonates as organ donors. These stories served as a convenient and appropriate backdrop to a June 9-10 Chicago conference on ethical, legal, and policy issues of organ and tissue donation sponsored by the Department of Medical Humanities at Southern Illinois University School of Medicine and the Live and Learn Organ Donation and Awareness Program of the Illinois Secretary of State. The following articles summarize the Mantle episode, the CEJA policy, and various presentations at the conference that emphasized the development of new frameworks to consider for increasing the nation's organ supply.     

Depressive Symptoms,Relational Turbulence,and the Reintegration Difficulty of Military Couples Following Wartime Deployment

Living organ donation offers a means of overcoming the shortage of viable organs available for transplant: a shortage particularly problematic among Hispanics. One barrier standing between those in need of a kidney and a successful transplant operation is an inability, and often lack of desire, to talk to loved ones about the need for a living donation. With an eye on future intervention approaches, and guided in part by the theory of planned behavior, this research effort sought to explore the factors associated with a willingness to engage in a conversation about a living donation with loved ones. Study 1, a phone survey of Hispanic Americans drawn from a Hispanic surname list, reveals that while upward of 90% of respondents would be willing to offer a kidney to a family member in need, and a similar percentage would be willing to accept a living donation if offered, only about half of respondents would feel comfortable initiating a conversation with family members if the respondent was in need of a living donation. Study 2, a survey of Hispanic American patients currently in need of a living kidney donation, revealed that perceived behavioral control accounted for 60% of the variance in future intentions to initiate a conversation among those who have yet to speak to a family member about becoming a living donor. Moreover, perceived behavioral control mediated the relationship between perceived asking appropriateness and future intentions to initiate a conversation. Lastly, recipient outcome expectations, asking appropriateness, and subjective norms were revealed to be predictive of perceived behavioral control. Implications for future living donor interventions focusing on increasing recipient-initiated conversations are discussed.     

"Can you spare an organ?": exploring Hispanic Americans' willingness to discuss living organ donation with loved ones

Living organ donation offers a means of overcoming the shortage of viable organs available for transplant: a shortage particularly problematic among Hispanics. One barrier standing between those in need of a kidney and a successful transplant operation is an inability, and often lack of desire, to talk to loved ones about the need for a living donation. With an eye on future intervention approaches, and guided in part by the theory of planned behavior, this research effort sought to explore the factors associated with a willingness to engage in a conversation about a living donation with loved ones. Study 1, a phone survey of Hispanic Americans drawn from a Hispanic surname list, reveals that while upward of 90% of respondents would be willing to offer a kidney to a family member in need, and a similar percentage would be willing to accept a living donation if offered, only about half of respondents would feel comfortable initiating a conversation with family members if the respondent was in need of a living donation. Study 2, a survey of Hispanic American patients currently in need of a living kidney donation, revealed that perceived behavioral control accounted for 60% of the variance in future intentions to initiate a conversation among those who have yet to speak to a family member about becoming a living donor. Moreover, perceived behavioral control mediated the relationship between perceived asking appropriateness and future intentions to initiate a conversation. Lastly, recipient outcome expectations, asking appropriateness, and subjective norms were revealed to be predictive of perceived behavioral control. Implications for future living donor interventions focusing on increasing recipient-initiated conversations are discussed.     

Problematising the ethics of organ donation after circulatory death in the UK

This commentary addresses the ethics of controlled organ donation after circulatory death (DCD) in the UK, a practice which has recently been revived as part of attempts to increase rates of organ donation. Despite being linked to growth in donor rates, bioethics and clinical scholars have drawn attention to the ethical issues which DCD poses for health professionals, particularly around the requirement to alter the end-of-life care of potential donors. In this commentary, the UK policy response to the ethics of DCD is examined by drawing on Foucault’s problematisation approach. This analyses the broader contexts within which the policy version of ethics for DCD has been created, and examines the potential implications of this form of ethics for the work of health professionals. It is argued that the policy version of ethics for DCD has a specific normalising role, which acts as an integral part of the efficiency drive by transplant medicine to optimise the potential for donation. In turn, this form of ethics is premised upon providing the right tools for health professionals to make ethical decisions around DCD. In so doing, it fails to account for the everyday practices of health professionals involved in end-of-life care. In conclusion, the commentary advocates bringing the social science perspective into debates on DCD, to ensure that the terms and practice of this technology, and its policies, are adequately problematised.     

Remapping the organ donation ethical climate: a care ethics consideration

Medicine, Health Care and Philosophy - Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ...     

Marketing organ donation around the globe.

Marketing to potential organ donors in different countries requires knowledge about religious beliefs and cultural norms that might influence the decision to donate. Because beliefs vary so widely from country to country, marketers need to consider whether a standardized or adaptive approach is suitable for marketing organ donation in different countries. This article takes a look at the variables that influence the decision to donate an organ and suggests marketing strategies that may work in various parts of the world.     

A Culturally Competent Approach to Exploring Barriers in Organ Donation Consent Among Haitian Immigrants: Formative Focus Group Findings and Implications

African Americans consent to donation less often than whites, have fears and misconceptions about donation specific to their cultures, and wait longer to receive transplants when the need is identified. However, there is less detailed empirical data on the transplant needs and barriers for Haitian immigrants. This paper describes focus group results designed to identify culturally grounded beliefs, attitudes, and barriers to organ donation. Results were used to design and implement the “Bay Lavi” (Give Life) campaign designed to raise awareness and increase organ donation consent among Haitian Immigrants.     

Determinants of the intention of Dutch adolescents to register as organ donors.

This article identifies relevant predictors of willingness among Dutch adolescents to register as posthumous organ and tissue donors. A cross-sectional survey was conducted among 1836 Dutch adolescents between 16 and 18 years of age who had not yet been approached for registration. Sixty-seven percent of the participants indicated that they were willing to register as organ donors. In order of greatest association, negative outcome beliefs, anxiety, social outcome expectations, involvement with organ donation issues, positive outcome beliefs, knowledge about organ donation registration, past behaviour, and sex were significant predictors of the willingness to register as organ donor. Religion and level of education had a significant bi-variate correlation with intention, but were not significant predictors after controlling for other variables. The results give clear suggestions for tailoring organ donation registration interventions to specific characteristics, beliefs and misconceptions of adolescents.     

"They don't want our blood": social inclusion and blood donation among African migrants in Australia

The current study examines how feelings of social inclusion influence migrant communities' predisposition to donate blood, focusing specifically on Sub-Saharan African communities in Australia. We begin by explicating the theoretical links between social inclusion, citizenship and blood donation before discussing local and international perspectives of blood donation among African migrant communities. Using qualitative methods comprising nine focus group discussions, held between March and April 2010, we argue that blood donation intentions are mediated by whether or not individuals feel included in their new host society. Real and perceived discrimination experienced by African migrants in their everyday social interactions or in institutional settings can act as a barrier to blood donation. We conclude that removing such barriers, thereby increasing rates of donation in migrant communities, will help to build social capital and inclusion. Strategies for how this can be achieved are outlined.     

Attitudes to kidney donation and registering as a donor among ethnic groups in the UK

BACKGROUND: Kidney organ donation rates continue to be low among ethnic minorities, leading to disproportionate numbers awaiting transplants, longer waiting times and problems of tissue matching. METHODS: A questionnaire survey was undertaken based on a convenience sample of general practice attenders to examine knowledge and attitudes to organ donation among ethnic groups. Responses were analysed using logistic regression for seven ethnic groups, controlling for age, gender and education. RESULTS: About 1606 (84.4%) of people approached agreed to participate, and 1536 (95.7%) questionnaires were fully completed. High proportions of all ethnic groups were aware of the possibility of leaving kidneys for transplant, and ethnic minorities were significantly more aware of the urgent need for donors. However, negative attitudes to organ donation involved multiple issues rather than a single barrier, including worries that their organs may be used for other purposes such as medical research, a lack of confidence that medical teams would try as hard to save the life of a donor, concerns about leaving the body 'intact' after death and questioning the value being a donor. CONCLUSIONS: Low rates of registration as a kidney donor among ethnic minorities are not explained by specific cultural or religious barriers. More adequate explanations require a broader focus and greater understanding of ways in which self-identity as a minority group, cultural and religious beliefs and practices, and the social capital of communities, interact to shape responses.     

Encouraging family discussion on the decision to donate organs: the role of the willingness to communicate scale

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.     

Encouraging Family Discussion on the Decision to Donate Organs: The Role of the Willingness to Communicate Scale

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.     

Legal aspects of transplant and donation

The Spanish model of organ and tissue donation enjoys great prestige in the world medical sphere and has been the object of study and imitation in different countries. Part of this success is due to the fact that since the year 1979 different legal norms have been enacted that have regulated and facilitated donation. The current legislation on the donation and transplant of organs and tissues is based on the principles of the gratuity and confidentiality of the donation, indicating the need for facilitating the formation of organisations at the level of the autonomous communities and at the national level. It also contains the requisites for donation of both live donors and deceased donors, establishing the norms for certification of death due to cardiorespiratory arrest and due to the irreversible cease of brain functions.