A-Level Coursework on "Organ Donation"

A-Level Coursework 10 pages (3330 words) Sources: 8

[EXCERPT] . . . .

Medicine

Organ Donation

Organ donation consists of the removal of organs and tissues from one human body for the purpose of transplanting them into another. Organ and tissue donors can be people of any age. Organ donations tend to be higher from deceased donors than from living ones. The laws surrounding organ donations are different from country to country. Some allow possible donors to give permission for or refuse donation while others give the choice to relatives. The need for organ donations is ever growing but the amounts that are being donated are not. There have been numerous studies done into why it is that people don't donate and several factors have been identified. This paper will explore these reasons along with the ethical issues that surround the idea of organ donation. Future trends will also be looked at that are attempting to increase the amount of transplantable organs that are available.

The crucial steps to increase the low rates of organ donors in many Western countries include ensuring that potential donors are identified and that authority is sought and obtained from family members of the potential donor before organ procurement can occur. Many studies have identified family consent as the critical connection in making sure that the organ supply meets the increasing demand for transplantable organs. Approximately half of the families approached for organ donation deny consent, a pattern which is constant in the UK (41%), USA (54%), and Australia (50%). One feature thought to play a central role in improving the likelihood of obtaining consent is family members' prior knowledge of their loved one's intentions to donate their organs upon death. Family members who are aware of an individual's positive attitude to donation and have previously discussed donation are more likely to fulfill the wishes of their family member by giving consent (Hyde and White, 2009).

There are many ways to express donation intentions including signing a donor card, registering on a donor register, or stating the preference on a driver's license. It is becoming increasingly clear that, regardless of the method by which an individual records their intentions, they also need to communicate their wishes to their family members or next-of-kin. This is a behavior that many individuals do not do. Previous research has identified the attitudes and beliefs impacting upon willingness to donate organs in general. Very few studies have investigated the reasons why individuals fail to communicate their donation decision. Reasons for not recording donation wishes identified in previous studies include a perceived family objection or lack of support for donation, distrust of the medical system, avoidance of bodily mutilation and premature death, having to defend one's decision to family, and lack of knowledge or being unsure about the donation process. Negative beliefs about discussing donation wishes include the perceived reluctance or objection of family members to talk, a lack of knowledge about organ donation, having to defend the donation decision to family, difficulty- starting the conversation, and talking about the death of one's self among others (Hyde and White, 2009).

Public education promotions are a very common strategy that is used to try and increase awareness about the need for more transplantable organs. Organ procurement associations, independently or in cooperation with private and public organizations and businesses, have put into practice innovative strategies to notify the public about organ donation and to encourage individuals to register as donors. An assortment of public education venues have been executed and evaluated, including motor vehicle offices, driver's education classes, community events, worksites, hospitals, and media. Moreover, some education campaigns have targeted specific audiences known to have less favorable attitudes toward organ donation, like minorities (Rodrigue, Cornell and Howard, 2009).

Regardless of the public education strategies used, organ donation outreach in mainstream media markets is less likely to reach minorities and persons with less formal education. Minorities are more likely to report mistrust of the health care system and misunderstanding about organ donation, so it is imperative that organ donation outreach efforts address these barriers in particular. Additionally, members of minority groups may be underexposed to positive messages about organ donation and may not know how to document their organ donation intentions. For instance, it has been found that more than half of the Hispanic-Americans report that they do not know how to sign up as an organ donor and more than one-third of them claim that they would sign a donor card if asked. Also, the print media contains very little coverage of minority-specific organ donation and transplantation issues. As demonstrated by several researchers to date, enhancing awareness of the need for organ donation in minorities requires more targeted public education campaigns that are culturally sensitive, use ambassadors that are known within the community, and use culturally similar community outreach educators. In light of the unbalanced representation of minorities on transplant waiting lists in the United States and the less favorable attitudes among minorities toward organ donation, effective strategies for disseminating culturally appropriate organ donation education must be urgently identified and evaluated (Rodrigue, Cornell and Howard, 2009).

Transplantation is often limited by the shortage of available organs along with many factors that contribute to this shortage. In Spain the main reason for loss of potential donors is rejection of their family members to donate. Family refusal leads to the loss of 1 out of every 4 or 5 probable donors. In addition to psychosocial factors in the population, one of the barriers that appear to prevent the procurement of more transplant organs is that a considerable number of hospital professionals may be opposed to organ donation. Typically, organ donation and transplantation activities have surrounded physicians, but it is now known that physicians have the most favorable attitudes toward organ donation of all hospital personnel. As a result it is thought that efforts should focus on other subgroups of hospital personnel. In this respect, nurses are fundamental in the organ donation and transplantation process. In addition, nurses often have more direct contact with patients and for longer periods of time than physicians do. This means that they have the opportunity to have a very important influence on patients. Consequently nurses' attitudes toward organ donation are thought to affect patients and their families as well as the general public in an important way that is reinforced by nurses' position as health care professionals. In this situation, it is a matter of great concern that various studies have shown that organ donation and transplantation generate stress among nurses and that nurse's lack information on the topic, although some researchers have reported that nurses have a very favorable attitudes (Zambudio, Martinez-Alarcon, Parrilla and Ramirez, 2009).

Only a few years after the first successes with kidney transplants from deceased donors, various authors began to study the psychosocial factors that influence donation. Initially the focus was on the general public, but later more emphasis was placed on studies of other health care workers, given that part of the problem with organ procurement is found within the hospitals themselves. Nurses are a fundamental subgroup of health care workers who look after patients and promote health in the population. In this respect, their attitudes toward health matters are fundamental, so if they are against donation, they generate a negative attitude toward donation among persons who might be exposed to such an attitude or they at least generate distrust about the matter. Information offered by health care personnel has a considerable influence on the general public. Moreover, the generation of a negative attitude in the general public from comments made by health care professionals is very difficult to reverse, given that the source of information holds a lot of credibility (Zambudio, Martinez-Alarcon, Parrilla and Ramirez, 2009).

Among the factors that influence attitudes on this topic, knowledge of the concept of brain death is very important. This classic factor has been described in the general population, but it is surprising to find it among nursing personnel. Nurses work in health care centers and have extensive training, so it is assumed that they understand the concept of brain death. Yet 34% of respondents did not understand this concept. This finding is similar with the main reason given for not donating organs: fear of apparent death. If a closer look is taken, the health care profession will be able to see that although they undertake campaigns in the general public, in schools, and so on, they have not ensured that their own personnel are well informed and fully understand what is being done. Therefore, it is important to provide information about brain death to health care professionals. In this respect, some experts have already highlighted that the establishment of a protocol about the diagnosis of brain death increases confidence in the process and reduces uncertainty (Zambudio, Martinez-Alarcon, Parrilla and Ramirez, 2009).

Fear of manipulation of the body is another factor that makes donation difficult. Thus, nurses have a more negative attitude toward donation when they are not prepared to have an autopsy carried out on themselves upon death if… READ MORE

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