Organ Donation
Abstract
Increasing rates of organ donation is essential in maintaining a good healthcare system. The number of individuals waiting for an organ continues to increase with time, but the number of available organs is not increasing at the same pace. Understanding the reasons why people do, and do not, join the organ donation register is an important first step into creating campaigns that can increase awareness of the issue and get more people to enroll in the organ donation register. This research report covers some of the recent research on why people join the organ register and the barriers to getting organs for transplantation, including family prevention. It also highlights some of the ways in which people can be encouraged to join the register. Recommendations are then made, based on the current research, about how to encourage more people to join the register and how to improve rates of organ transplantation.
Increasing Organ Donation
Organ donation is an important topic in the medical sciences. Organs are required to save the lives of a number of chronically ill patients, but for most of these patients a suitable organ will never be found. This is due to the fact that there are low rates of organ donation. The challenge for many health departments is to assess the reason why rates of organ donation are so low and to assess possible methods to increase the rates in order to save lives. Understanding the reason why people do or do not participate in organ donation is key to increasing the number of donations overall, which in turn has a benefit for those on the waiting list for organ donation. The aim of this project is to assess the reasons why people do, or do not, join the organ donor register, and the ways in which more people can be encouraged to join the donor list to increase the available pool of organ donors.
Findings
One of the main reasons people consider organ donation is the number of lives that they can save by being a donor, as one donor can potentially provide organs to ten recipients (organdonor.gov, 2014). There is a huge shortage of organs that are available for transplantation. This issue is compounded because the waiting list increases steadily but the number of organ donors does not. Several other factors are suggested in various sources, including the ability to help grieving families. However, it remains evident that more research has been done into the reasons why people are unwilling to donate rather than the motivations people have to register as donors. The number of potential recipients on the organ donor waiting list may serve as a strong motivator for encouraging people to join the donor register. Figure 1 below shows the number of people awaiting organ transplants compared with the available number of organs.
Figure 1: The Number of People Waiting for an Organ Transplant Continues to Rise (organdonor.gov, 2014)
There are a number of different reasons why an individual may not want to join the organ donor register. These include the “ick” factor, which is feelings of disgust about the procedure, the “jinx” factor, which makes people think that joining the register makes them more likely to die, medical mistrust (usually believing a doctor will let them die more easily if they are on the register) and the need to preserve body integrity after death. The proportion of individuals that gave these responses is shown in Figure 2. The “ick” factor is perhaps one of the most important, and is found to be particularly common in terms of corneal transplants (O’Caroll et al., 2011). In these cases, individuals have no ethical or moral objection to organ donation, but find the idea that their organs may be removed after death.
Figure 2: Reasons Given for Not Joining the Organ Donation Register (O’Caroll et al., 2011)
The “jinx” factor is also an important consideration to make, as it highlights that some individuals are worried that joining the register will make them more likely to have an accident. This is statistically untrue (O’Caroll et al., 2011) and as such could be an important source of changing perceptions about organ donation. The final issue is medical mistrust. In the case of doctors being less likely to save an individual if they are on the organ transplant list, this is also statistically unlikely (O’Caroll et al., 2011). Again, this could provide a potential source for creating campaigns to dispel myths about joining the transplant list.
Family members can also be an issue when it comes to organ donation. In some cases, an individual can express their wishes to donate organs after they have died, but families have refused. The UK has one of the highest rates of family refusal in the world, which suggests that work needs to be done in cementing the individual’s wishes to prevent miscommunication. Figure 3 shows the number of family refusals per country. It is important to understand why this miscommunication happens and why families can refuse to carry out the individual’s wishes. It may be useful to conduct further research into this area to give insight into the problem.
Figure 3: Family Refusal Rates for Organ Donation by Country (NHSBT, 2015)
There are a number of ways that countries have tried to boost the number of people on the organ register. Israel, for example, have given priority to donors over non-donors when it comes to receiving an organ for transplantation (PRI, 2010). This helps to encourage people to join the donor register as it highlights that an equal number of people need to donate as to receive to solve the problem of organ donation. It also makes the point that we all may need an organ one day, and that the only way to get around this issue is to ensure that the organ donor register is filled with individuals that are able to join it. The Israeli approach is an interesting way of encouraging people to join, but is worth bearing in mind when confronting future challenges.
Conclusion
There are a number of reasons why an individual may or may not wish to donate their organs after death. The most common reason why an individual is motivated to donate is that it can help a large number of people, particularly with respect to the steadily increasing number of patients on the donation waiting list. Reasons that individuals may not be on the donor list include the “ick” factor, the “jinx” factor, medical mistrust, and the need to preserve bodily integrity. Family members also pose a problem, particularly when there is a conflict between the wishes of the individual and the beliefs of family members. This research report highlights some of the strategies that have been used to increase the number of individuals on the organ donor list to help relieve some of the pressure on organizations needing organs for transplantation.
Recommendations
The health department should focus on promoting the fact that organ donation saves lives to encourage people to join the register. More information should be given to educate potential donors about the process to remove factors like the “ick” factor. They can highlight the number of people that are waiting for an organ by making campaigns at hospitals, and by making PSAs. Leaflets in healthcare offices and hospitals, for example, can be widely distributed for a low cost and have a big impact on how people feel about organ donation.
More research should be conducted into the reasons why people choose to join the donor register, as there is little information about the motivational factors behind joining. This can be done by the health department, or by nursing researchers. Surveys can be distributed to willing participants to assess their reasons for joining the register, and statistically analyzed to give insight into the issue.
Individuals should be encouraged to have conversations with their family about their wishes should they pass away. This can prevent issues whereby family members do not follow the wishes of the deceased, even if they are on the register. The health department can do this by releasing PSAs that promote discussions between individuals and their families about their wishes should they pass away.
References
organdonor.gov, 2014. The Need Is Real: Data [WWW Document]. URL http://www.organdonor.gov/about/data.html (accessed 5.26.16).
http://www.liveonny.org/about-donation/why-be-an-organ-donor/
O’Carroll, R.E., Foster, C., McGeechan, G., Sandford, K., Ferguson, E., 2011. The “ick” factor, anticipated regret, and willingness to become an organ donor. Health Psychology 30, 236.
NHSBT, 2015. Consent Authorisation - International perspectives and evidence base [WWW Document]. ODT Clinical Site. URL http://www.odt.nhs.uk/donation/deceased-donation/consent-authorisation/international-perspectives.asp (accessed 5.26.16).
PRI. (2010). Global organ shortage. Retrieved June 4, 2016, from http://www.pri.org/stories/2010-01-25/global-organ-shortage
