Improving Organ Donation Rates in the Black Community

Abstract

The risk of developing end-stage renal disease is four times higher in the Black than in the White population. The number of Blacks on dialysis or on the waiting list for transplantation continues to grow due to an insufficient number of suitable organ donors. Same-race transplants have been shown to be more successful when blood types and human leucocyte antigens are used as the matching criteria. The low levels of organ donation by Blacks has been attributed to a number of factors. This article reviews some of the more complex factors (e.g., social practices, religious beliefs, and cultural expectations) affecting the organ donation decision. In addition, some implications and strategies are suggested that may increase the rate of organ donation in the Black community.

Understanding African Americans’ views of the trustworthiness of physicians

“…Our study is one of the few that has focused on understanding trust and distrust in physicians from an African‐American perspective. There have been a number of studies that have focused on trust in mixed populations, 4,8,9,24,25 distrust of research as a barrier to research participation among African Americans 12,15–18 and the relationship between trust or distrust and participation and satisfaction with medical care among African‐American patients 19–22,26,27 . Our findings add to this literature by highlighting factors that specifically contribute to distrust and trust of physicians among African Americans.…”

“…This lack of consistency may be due to the fact that these studies focused on trust and not distrust. Studies that have focused on distrust have shown significant differences between African Americans and Caucasians in their distrust of the motives of the medical profession in withdrawal of life‐sustaining technology, pursuit of organ donation, research, and health care over all 12,15–22 …”

“…Studies that have focused on distrust have shown significant differences between African Americans and Caucasians in their distrust of the motives of the medical profession in withdrawal of life-sustaining technology, pursuit of organ donation, research, and health care over all. 12,[15][16][17][18][19][20][21][22] The objective of this study was to better understand what trust and distrust in physicians mean to African Americans. We were interested in the determinants of trust and distrust in physicians, the relationship between trust and distrust and their impact on participants' care-seeking behavior.…”

Culture and Ethnicity in Clinical Care

“…African Americans are more likely to believe that, if hospitalized, they risk having their transplantable organs stolen, 30 and are reluctant to consent to organ donation for fear of premature declaration of death or less intensive medical care. 84,88 However, African Ameri-cans also are less likely to be approached for organ donation 89 in part because white organ procurement staff are more uncomfortable making requests of minority patients. 90 Afro-Caribbeans may decline cadaveric organ donation because such postmortem manipulations would anger the spirits of the deceased.…”

Model Organ Description Protocols for Completion by Transplant Surgeons Using Organs Procured from Medical Examiner Cases

“…a lack of public education addressing misconceptions; cultural, racial, psychological, economic, and practical factors; a lack of staff education and administrative involvement 2,5,12,[17][18][19][20]25,26,30,[32][33][34][35][36] ; and medical-legal problems in medical examiner and coroner offices. 9,23,29,[37][38][39] Positive effects with the Transplant Games and an interesting phenomenon called the "Island Effect," which supports the concept of decentralization and close communication have been reported.…”