Organ donation: what else can be done besides legislature?

Abstract

With the ongoing organ shortage for transplantation, Singapore has adopted an organ opt-out scheme: Human Organ Transplant Act (HOTA) that presumes consent unless specified otherwise. Likewise, receptivity of doctors and medical students (MS), as future doctors, can positively influence organ donation (OD) rates. We explored the knowledge and attitudes of MS toward OD. MS from all five yr of medical school were recruited using self-administered questionnaires. There were 294 completed questionnaires with 49.3% males and 45.6% pre-clinical students. The MS were generally knowledgeable about organ transplantation, but deficient in the knowledge of some aspects of HOTA. The majority of the MS were receptive toward OD. Traditional values rather than religion were possible barriers toward OD. 50.7% of the MS were concerned that donated organs may be inappropriately used, while 32% had concerns that doctors would prematurely terminate treatment if the patient is a potential organ donor. Fewer clinical students shared such concerns, compared with the pre-clinical students. The MS have a good understanding of basic tenets of OD and are receptive toward OD. Potential barriers for OD advocation are local traditional values and reservations regarding the appropriate use of harvested organs and provision of appropriate care to donor patients. These concerns are areas to address.

NHS staff awareness, attitudes and actions towards the change in organ donation law in England—results of the #options survey 2020

“…The level of support for the change in legislation observed in NHS staff respondents in this study is also reassuring, they are higher than levels of support identified in other international studies where there is opt-out legislation [ 13 , 22 ]. It is comparable to Scotland where prior to the planned change to opt-out it was reported that staff felt it would have a positive impact [ 23 ].…”

Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

“…Educational policies aimed at decreasing family refusal are essential because most transplants in Brazil come from deceased donors and, by law, donations rely on family consent. As constantly advocated in the literature, education is a fundamental tool for increasing the individual autonomy for making conscious decisions, improving awareness, building a generally positive attitude regarding ODT, and aiding choices about organ donation …”

“…It is worth noting that a family's decision about organ donation occurs while they are mourning the loss of a loved one, often without previous thought on the matter . Other aggravating factors are dissatisfaction with the care received by the patient, the distrust of the National Transplant System organ allocation system, and the unfamiliarity with the concept of brain death, frequently resulting in insecurity about the diagnosis of death and the irreversibility of this clinical status . The doubts prevail when the health team fails to apply the technical knowledge and interpersonal abilities required to provide informed support and create an empathetic connection with the family during the organ donation interview …”

Psychosocial Factors, Knowledge and Attitudes Influencing Skin and Heart Valve Donation among Healthcare Professionals in Singapore

“…Unlike the American and European societies, who are generally more open to donation, our society comprising predominantly of Chinese and Malay societies have traditional cultural values, which result in greater antipathy towards organ/tissue donation. 9 This was evident in various studies, for instance, 27% of 2930 Chinese participants would not consent to donate their own organs after their passing due to the traditional Chinese belief of the necessity to have an intact body after death for a good afterlife. 10,11 Another evidence of traditional cultural values influencing people's decision to donate tissue/organs is the statistics obtained from 2000 to 2010 by National Transplant Resource Centre, Kuala Lumpur, which reported that donation among the Malay community (the dominant ethnic group in Malaysia) contributed to only 6.36% of the total organ donation as compared to 61.86% by Chinese and 31.78% by Indians; the study cited the Malay community's perception that their religion, Islam, did not permit them to donate tissue/organs as the primary reason for their low donation rates.…”