Public attitudes and behavior regarding organ donation

Organ transplantation has been the subject of much attention; unfortunately, relatively little has been published about public attitudes toward organ donation. To better document public perceptions on organ donation, a telephone survey of a nationally representative sample of 2,056 respondents was conducted. We found that nearly 94% of the population had heard about organ transplantation, but only 19% of these people carried donor cards. The results indicated that people are somewhat more likely to donate the organs of a relative who had just died (53%) than they are to donate their own organs (50%). People were most likely to donate kidneys (50%) and least likely to donate skin (40%). Most respondents (58%) felt that next of kin should not be able to override a person's desire to donate organs as signified by an organ donor card. Few people (7%) supported the concept of presumed consent. We conclude that while the public is supportive of organ transplantation, it is not overly enthusiastic about organ donation. Awareness of this paradox on behalf of the public may actually facilitate organ donation.     

Opt-out organ donation without presumptions

This paper defends an 'opt-out' scheme for organ procurement, by distinguishing this system from 'presumed consent' (which the author regards as an erroneous justification of it). It, first, stresses the moral importance of increasing the supply of organs and argues that making donation easier need not conflict with altruism. It then goes on to explore one way that donation can be increased, namely by adopting an opt-out system, in which cadaveric organs are used unless the deceased (or their family) registered an objection. Such policies are often labelled 'presumed consent', but it is argued that critics are right to be sceptical of this idea-consent is shown to be an action, rather than a mental attitude, and thus not something that can be presumed. Either someone has consented or they have not, whatever their attitude to the use of their organs. Thankfully, an opt-out scheme need not rest on the presumption of consent. Actual consent can be given implicitly, by one's actions, so it is argued that the failure to register an objection (given certain background conditions) should itself be taken as sign of consent. Therefore, it is permissible to use the organs of someone who did not opt out, because they have-by their silence-actually consented.     

Communication strategies for organ donation

A country, state or hospital may have the latest medical technology and infrastructure as well as qualified professionals for organ transplantation, but unless there is an adequate donor population the waiting lists for transplants will continue to be long and for some patients, hopeless. Public and professional awareness programmes are key factor in the donation process. Social education that explains the life-saving benefits of organ transplantation, the enormous need for organ donation, the concept of brain death and religious teachings related to these issues is vital for creating a conducive environment for the organ transplant co-ordinator or physician soliciting the donation. The education of hospital medical, nursing and administrative personnel is also essential to both miximise opportunities for donation, as well as to prevent loss of potential organs after donor consent. Other target populations are medical examiners or coroners, and police personnel under whose jurisdiction the donations occur, as their co-operation and guidance is necessary for meeting statutory requirements. The involvement of government officials and politicians is also valuable, as their active intervention is essential for the introduction and amendment of rules and laws to promote the donation and transplantation of organs. The present paper describes communication strategies for the development of an efficient education plan that will provide information about organ transplantation, explain the desired outcome, address potential queries, misconceptions or obstacles, and identify potential sources of support.     

The subtle politics of organ donation: a proposal.

Organs available for transplantation are scarce and valuable medical resources and decisions about who is to receive them should not be made more difficult by complicated calculations of desert. Consideration of likely clinical outcome must always take priority when allocating such a precious resource otherwise there is a danger of wasting that resource. However, desert may be a relevant concern in decision-making where the clinical risk is identical between two or more potential recipients of organs. Unlikely as this scenario is, such a decision procedure makes clear the interdependence of organ recipient and organ donor and hints at potential disadvantages for those who are willing to accept but unwilling to donate organs (free-riders). A combined opting-out and preference system weakens many of the objections to opting-out systems and may make the decision to donate organs on behalf of their deceased relatives easier for families.     

Attitudes toward organ donation in China

Background  Organ transplantation represents an important advance in modern medical science, and it has benefited many patients with organ failure; however, the severe deficiency of organ sources has been a bottleneck that has limited the benefits this technology can bring. The aim of this study was to show the results of a survey on Chinese people’s awareness and attitudes toward organ donation.

Methods  We designed a questionnaire regarding organ donation consisting of 20 short questions, which were distributed to 10 groups. Most of the questions were multiple-choice; the core question related to people’s attitudes to organ donation and the development of organ donation. The survey was held in the outpatient hall of Beijing Chao-Yang Hospital, a commercial district, and four professional colleges. Participants were randomly selected, and answered questions about gender, age, educational background, profession, and study major.

Results  In all, 2930 valid responses were received. Male:female ratio was nearly 1:1.2 (mean age 38 years). Over 90.0% of participants knew about organ transplantation and which organs could be transplanted; more than 95.0% knew about organ donation, but the time they had been aware of it varied. Nearly 90.0% of the participants approved of deceased organ donation; 73.0% indicated they would like to donate their organs post mortem. Participants who knew more about organ failure and organ transplantation were more likely to support organ donation. College students were very positive about organ donation, though as they gain professional knowledge their attitudes may change. Altogether, 65.3% of participants approved of living organ donation, which was obviously lower than the figure for deceased organ donation (P <0.05). In all, 85.7% of participants approved of compensation to the deceased donor’s family. To promote organ donation in China, 62.9% of participants indicated that the public’s knowledge about organ donation should be increased via the media and various kinds of education. Only 20.0% of the participants believed that legislation was required.

Conclusions  We conclude that at present the Chinese public has a basic understanding about organ transplantation and donation. The majority respondents were in favor of deceased organ donation and were willing to donate their own organs after death.

     

Parental attitudes toward pediatric organ donation: a survey.

We conducted a telephone survey of parents in the National Capital Region to assess their intention to donate their child's organs and to provide physicians with information that could help alleviate their concerns about approaching parents for consent. Of 339 parents who agreed to answer questions after being given details of their child's "death" 288 (85%) said that they would be willing to donate their child's organs. The degree of willingness was associated with the certainty of death, altruism and empathy toward children in need of an organ, previous discussion of organ donation with a family member and knowledge of an adolescent or adult child's attitude toward donation. Factors that inhibited the intention to donate included uncertainty of death, insufficient information from medical professionals and fear of multilation. The child's age was not significantly associated with intention to donate. Concordance between the results and actual donation rates in Canada and the United States supports the generalizability of the survey findings.     

大学生对器官移植和器官捐献认知状况及态度的调查研究

通过对保定市5所高校学生进行关于器官移植和器官捐献认知状况及态度的调查分析，结果显示：大学生对器官移植及身后器官捐献知识的了解甚少，医学生掌握得较好，但仍不容乐观，回答完全正确的比例仅为28．81％；未能充分利用学校教育、报刊杂志、广播电视等媒体进行宣传；影响捐献器官的主要因素是对器官捐献知识及社会意义的了解程度。因此，建议充分利用各种媒体加强有关知识的宣传。     

Cadaveric organ donation: ethical considerations for a new approach.

We review various organ procurement strategies from ethical and practical perspectives to understand why these strategies have been relatively unsuccessful. We propose that the CMA recommend the implementation of a required-request policy in hospitals. We also propose a possible new approach in which people from the age of 18 years would voluntarily enrol in an organ donation program, agreeing to permit all usable organs to be taken for transplantation at the time of death. In return they would have priority for receiving organs made available by the program. We believe that this program would save lives, respect the donor's autonomy and satisfy the principles of justice and beneficence.     

Attitudes on organ donation among Hawaii physicians

A survey of physicians attending the recent Hawaii Medical Association meeting was conducted in order to assess physician attitudes on organ donation. Physicians were asked 6 questions and demographics were collected. Results indicate that Hawaii physicians generally support organ donation and are aware of some of the current federal legislation regarding donation.