Disgust sensitivity and attitudes toward organ donation among African-American college students.

241 African-American college students (94 men and 147 women, mean age = 20.3 +/- 3.4 yr.) completed the 1994 Disgust Scale of Haidt, McCauley, and Rozin and a modified form of Parisi-Rizzo's 1987 Attitudes Toward Organ Donation Scale (negative subscale only) as well as a behavioral measure of intention to donate organs after death. Analyses indicated that the higher the disgust sensitivity, the more negative the attitude toward organ donation and the less likely the student was to indicate intent to donate organs. It was further shown that negative attitudes toward organ donation mediated the relationship between disgust sensitivity and the behavioral intention measure. Results highlight the complexity of the issues surrounding organ donation within an African-American population and provide additional empirical evidence for the development of a theoretical model to explain the organ donation phenomenon.     

Intrinsic-Extrinsic Religiosity and University Students' Willingness to Donate Organs Posthumously

This research focuses on the links between intrinsic and extrinsic religious orientations as they relate to willingness to donate organs posthumously. Participants responded to a factual test of their knowledge about organ donation, indicated their degree of willingness to donate organs, and filled out personality inventories measuring their intrinsic and extrinsic orientations. The data indicated a high level of factual knowledge about organ donation. Also, contrary to Allport's (1966) arguments, people with an intrinsic religious orientation were not more likely to donate their organs, nor were people with an extrinsic religious orientation less likely to do so. Instead, it was found that intrinsic religiosity was unrelated to willingness to donate organs and that extrinsics with strong social orientations were more willing to donate their organs. Discussion centers on the need to develop more psy-chometrically sound measures of mature religiosity as a means of conducting a fairer test of Allport's original theorizing about intrinsic religiosity.     

Value Priorities and Organ Donation in Young Adults

This research identifies major personal values among American university students that predict organ-donation registration with the Department of Motor Vehicles. Participants responded to a factual test of their knowledge about organ donation, indicated whether or not they had registered as posthumous donors, and filled out a personality inventory measuring their personal values (Schwartz, 1992, 1994). The data indicated a high level of factual knowledge about organ donation; and the greater the level of knowledge, the more likely participants were registered to donate their organs. Also, participants higher in benevolence, universalism, achievement, and stimulation were more likely to have registered to donate their organs. The results are discussed in terms of the need to develop more effective health-communication campaigns by using specific health-education messages tailored to students majoring in different disciplines or to people in various occupations as a means of increasing their willingness to donate.     

Transplantation: Biomedical and Ethical Concerns Raised by the Cloning and Stem-Cell Debate

Transplantation is becoming an increasingly more common approach to treatment of diseases of organ failure, making organ donation an important means of saving lives. Most world religions find organ donation for the purpose of transplantation to be acceptable, and some even encourage members to donate their organs as a gift of love to others. Recent developments, including artificial organs, transplants from nonhuman species, use of stem cells, and cloning, are impacting the field of transplantation. These new approaches should be discussed with bioethical considerations in mind, particularly the notion of human beings as a unity of body and spirit.     

Effects of Refutational Messages,Thought Provocation,and Decision Deadlines on Signing to Donate Organs1

Across three experiments college students were given refutational messages or other treatments encouraging signing drivers' licenses to donate bodily organs in case of accidental death. An attitudinal measure (willingness to sign) predicted observed signing behavior, but relatively weakly. A measure of behavioral expectation to sign or not to sign predicted more strongly. A discussion with family was encouraged, the impact of that discussion also predicted signing but less strongly so. In Study 1 groups given a refutational message signed at no greater rates than a group given a control message. In Study 2 a refutational message group and a group asked to think about donating for 2 min signed at higher rates than a true control group. In Study 3 groups asked to decide whether or not to sign by a certain date and time signed at a higher rate than a refutational message group as in earlier studies. These procedures are recommended for organ donation signing campaigns.     

Individualism–collectivism and organ donation intentions

This article investigates the impact of individualism–collectivism on a person's willingness to donate organs. In Study 1, an online survey showed that individualism–collectivism was significantly and positively associated with participants' willingness to register as organ donors while perceived benefit mediated this relationship. Study 2 demonstrated the causal effect of individualism–collectivism on organ donation intentions using a priming technique. Participants primed with collectivism were more likely to register as organ donors than those primed with individualism. Our findings provide unique insights into whether cultural values (i.e., individualism–collectivism) can predict people's organ donation intentions.     

Solving the Dilemma: Family Communication About Organ Donation Among Chinese,Japanese, and Caucasian American College Students1

This study surveyed 800 students in the United States, Hong Kong, and Japan to determine associations between the components of the theory of reasoned action and early communication about organ‐donation decisions within the family. Results showed that among the 3 ethnic groups, Japanese students reported the least favorable attitudes and subjective norms about organ donation and were also the least likely to discuss this topic with their families. Moreover, the moderating effect of ethnicity indicated that attitudes were a significant factor of family discussion among American and Japanese students but not among Chinese students. Subjective norms were more predictive of family discussion among Chinese students than among American and Japanese students.     

Attitudes and Behaviors Regarding Organ Donation: a Study on Officials of Religion in Turkey

The aim of this study is to determine the attitudes and behaviors of religious scholars regarding organ donation and transplantation. In this study, 540 officials working in the Department of Religious Affairs in Kayseri, Turkey, were included. Overall, 86.6% response rate (n = 468) was achieved. Although a majority of the officials of religion in this study stated that they believed in the importance of organ donation (90.8%), the rate of considering donation (57.9%) and the donation rate (1.1%) were found to be substantially low. There is a difference between the employment status and willingness to donate organs. The rate of willingness to donate was significantly high in men than women. And also was high in imams and preachers. Regarding the sources of information, the majority of the respondents (70.0%) cited mass media. Overall, 15.3% cited school education and 42.0% religious publications. The most common question (83.1%) that was asked was “whether or not organ donation was suitable for Muslim religious”. Our study revealed that although the research groups have positive ideas about organ donation and transplantation, their role was low in informing and motivating people about organ donation and transplantation.     

An exploratory analysis of sex differences in gossip

This study examined sex differences in the quantity, targets, tone, and topics of gossip in the conversations of 76 male and 120 female college students. Contrary to popular beliefs, results indicated that the gossip of men and women contained similarities as well as differences. The data revealed that women spent more time gossiping than men and that women were much more likely than men to gossip about close friends and family members. However, no significant sex differences were uncovered regarding the derogatory tone of gossip and men and women were found to gossip about many of the same topics.We are grateful to Karl Seman, Marilla Ross, Robin Ansher, and Jack Schmaly, who served as observers during the data-collection phase of the study, and to Richard Weiner, who conducted the statistical analysis. We also gratefully acknowledge the contributions made by Ralph L. Rosnow.     

Earning points for moral behavior: organ allocation based on reciprocity

Anticipating the reevaluation of the Dutch organ procurement system, in late 2003 the Rathenau Institute published a study entitled 'Gift or Contribution?' In this study, the author, Govert den Hartogh, carries out a thorough moral analysis of the problem of organ shortage and fair allocation of organs. He suggests there should be a change in mentality whereby organ donation is no longer viewed in terms of charity and the volunteer spirit, but rather in terms of duty and reciprocity. The procurement and allocation of donor organs should be seen as a system of mutually assured help. Fair allocation would imply to give priority to those who recognize and comply with their duty: the registered donors. The idea of viewing organ donation as an undertaking involving mutual benefit rather than as a matter of charity, however, is not new. Notwithstanding the fact that reference to charity and altruism is not required in order for the organ donation to be of moral significance, we will argue against the reciprocity-based scenario. Steering organ allocation towards those who are themselves willing to donate organs is both an ineffective and morally questionable means of attempting to counter organ shortage.     

Development of the University of Pittsburgh Medical Center policy for the care of terminally ill patients who may become organ donors after death following the removal of life support

In the mid 1980s it was apparent that the need for organ donors exceeded those willing to donate. Some University of Pittsburgh Medical Center (UPMC) physicians initiated discussion of possible new organ donor categories including individuals pronounced dead by traditional cardiac criteria. However, they reached no conclusion and dropped the discussion. In the late 1980s and the early 1990s, four cases arose in which dying patients or their families requested organ donation following the elective removal of mechanical ventilation. Controversy surrounding these cases precipitated open discussion of the use of organ donors pronounced dead on the basis of cardiac criteria. Prolonged deliberations by many committees in the absence of precedent ultimately resulted in what is, to our knowledge, the country's first policy for organ donation following elective removal of life support. The policy is intricate and conservative. Care was taken to include as many interested parties as possible in an effort to achieve representative and broad based support. This paper describes the development of the UPMC policy on non-heart-beating organ donation.     

Consenting to Donate Organs: Whose Wishes Carry the Most Weight?

An experimental simulation methodology examined how people weigh the wishes of the donor and the next-of-kin in recommending whether the latter should consent to donate the organs of a deceased loved one. Subjects read several brief stories, each describing a young adult who had died suddenly and whose kin faced the decision of whether to donate their loved one's organs. Each scenario had four versions, identical except for minor wording changes providing information about the organ donation wish of the potential donor and the next-of-kin. Subjects indicated "yes,""no," or "I'm undecided" about whether the kin should donate the organs. Subjects weighted the wishes of the deceased much more heavily than their own or those of the next-of-kin when those wishes were stated directly. When the deceased's wishes had to be inferred indirectly, attitudes of the next-of-kin and the experimental subject affected the decision much more. Implications for organ procurement practice are considered.     

Presumed consent for organ preservation in uncontrolled donation after cardiac death in the United States: a public policy with serious consequences

Organ donation after cessation of circulation and respiration, both controlled and uncontrolled, has been proposed by the Institute of Medicine as a way to increase opportunities for organ procurement. Despite claims to the contrary, both forms of controlled and uncontrolled donation after cardiac death raise significant ethical and legal issues. Identified causes for concern include absence of agreement on criteria for the declaration of death, nonexistence of universal guidelines for duration before stopping resuscitation efforts and techniques, and assumption of presumed intent to donate for the purpose of initiating temporary organ-preservation interventions when no expressed consent to donate is present. From a legal point of view, not having scientifically valid criteria of cessation of circulation and respiration for declaring death could lead to a conclusion that organ procurement itself is the proximate cause of death. Although the revised Uniform Anatomical Gift Act of 2006 provides broad immunity to those involved in organ-procurement activities, courts have yet to provide an opinion on whether persons can be held liable for injuries arising from the determination of death itself. Preserving organs in uncontrolled donation after cardiac death requires the administration of life-support systems such as extracorporeal membrane oxygenation. These life-support systems can lead to return of signs of life that, in turn, have to be deliberately suppressed by the administration of pharmacological agents. Finally, allowing temporary organ-preservation interventions without expressed consent is inherently a violation of the principle of respect for a person's autonomy. Proponents of organ donation from uncontrolled donation after cardiac death, on the other hand, claim that these nonconsensual interventions enhance respect for autonomy by allowing people, through surrogate decision making, to execute their right to donate organs. However, the lack of transparency and the absence of protection of individual autonomy, for the sake of maximizing procurement opportunities, have placed the current organ-donation system of opting-in in great jeopardy. Equally as important, current policies enabling and enhancing organ procurement practices, pose challenges to the constitutional rights of individuals in a pluralistic society as these policies are founded on flawed medical standards for declaring death.     

Banking on brains: Insights of brain donor relatives and friends from an experiential perspective

Brain donation is critical to understand the pathological causes of neurodegenerative diseases. Increasing levels of donation requires an understanding of those factors that both encourage and deter donation. At present, there are few studies of how people understand, feel and decide about brain donation for scientific research. This qualitative experiential study contributes to the growing literature on brain donation through its specific focus on how the donation process is experienced from the perspectives of family members and friends. Nineteen semi-structured interviews were analysed using a phenomenologically informed thematic analysis. Four themes were derived from the analysis, three of which are described in detail: Making the decision to donate; a personal perspective on the donation process; the significance of the brain; beliefs about brain donation. In particular, the thematic analysis highlights the variation of individual decision making and the emotions and reasons underpinning such decisions. Key conclusions include the importance of integrated practice amongst relevant healthcare professionals as well as the need for supportive and informed communication. Also, in light of the finding that the brain assumed no special significance for most participants, the value of the distinction between brain donation for research purposes and organ transplantation is questioned.     

Banking on brains: Insights of brain donor relatives and friends from an experiential perspective

Brain donation is critical to understand the pathological causes of neurodegenerative diseases. Increasing levels of donation requires an understanding of those factors that both encourage and deter donation. At present, there are few studies of how people understand, feel and decide about brain donation for scientific research. This qualitative experiential study contributes to the growing literature on brain donation through its specific focus on how the donation process is experienced from the perspectives of family members and friends. Nineteen semi-structured interviews were analysed using a phenomenologically informed thematic analysis. Four themes were derived from the analysis, three of which are described in detail: Making the decision to donate; a personal perspective on the donation process; the significance of the brain; beliefs about brain donation. In particular, the thematic analysis highlights the variation of individual decision making and the emotions and reasons underpinning such decisions. Key conclusions include the importance of integrated practice amongst relevant healthcare professionals as well as the need for supportive and informed communication. Also, in light of the finding that the brain assumed no special significance for most participants, the value of the distinction between brain donation for research purposes and organ transplantation is questioned.     

Family perception of the process of organ donation. Qualitative psychosocial analysis of the subjective interpretation of donor and nondonor families

Family perception of organ donation has been explored by numerous authors using statements by the people who decided whether or not to donate the organs of a relative in a situation of brain death. Within this tradition, in this work, we analyze the discourse of six families who granted permission for organ donation and three who refused. We describe the process-based interpretation of this experience and identify psychosocial variables and processes that further our understanding of the decision finally adopted. We have identified two heuristics that guide family decision when organ donation is requested: the explicit or inferred will of the deceased and family attitudes to organ donation and transplant. It is postulated that the interaction of these two factors explains a large amount of the decisions made. We also hypothesize that a marked discrepancy between these two factors increases the importance of other aspects, especially the role of the transplant coordinator and of other healthcare personnel. These results support, at a social level, the implementation of transplant promotion programs; and at a healthcare level, the combined use of techniques of crisis intervention and attitude change.     

The Ohio study in light of national data and clinical experience

The Siminoff, Burant, and Youngner study in Ohio is strikingly consistent with data from a national study. Both suggest that there might be significant public acceptance of future policies that violate the dead donor rule, or that further extend the boundary between life and death to include brain-damaged patients short of "brain death." Experience with donation suggests that many individuals would donate their loved ones' organs when they have concluded that the brain injury is not survivable, even if all the criteria for "brain death" are not met. It would be very helpful to have research on those who have gone through the real-life clinical situation. Based on the findings of this study and the increasing demand for organs, it may be appropriate for public policy to allow for ways to increase organ procurement from individuals who are not fully "brain dead" beyond the current method of procurement after cardiac death, but any change in this area should go slowly and with significant public input.     

The role of psychosocial factors in predicting the formalized human milk donation to nonprofit milk banks

Human milk donation is important for improving the development of preterm infants. However, despite the importance of donating the human milk, relatively little research has tested which factors predict this form of donation. This study assessed the association between the psychosocial factors and formalized milk donation to a nonprofit milk bank. This study used a cross-sectional design. Breastfeeding mothers (N = 556) completed measures assessing altruism, pride, instrumental and affective attitudes, subjective norm, perceived behavioral control, self-efficacy, anxiety, and intention to donate human milk to a nonprofit milk bank. We also assessed whether participants requested additional information about donating the human milk. Instrumental and affective attitude, subjective norm, and self-efficacy were positively associated with intention to donate milk. Self-efficacy and intention were also uniquely associated with requesting the additional information. The intention to engage in the formalized milk donation to a nonprofit milk bank appears to be more likely if women view this action as beneficial, believe significant others support the action and think they have the ability to undertake this action. Women who think they have the ability to undertake this action and are willing to donate are more likely to request additional information. These findings might inform future experimental research and campaigns on the human milk donation.     

Cultural Diversity and Patients with Reduced Capacity: The Use of Ethics Consultation to Advocate for Mentally Handicapped Persons in Living Organ Donation

Theoretical Medicine and Bioethics - Living organ donation will soon become the source of the majority of organs donations for transplant. Should mentally handicapped people be allowed to donate,...