Religion and the decision to donate organs: Exploring the potential role of religious leaders

The two‐step flow model of communication (Katz, 1957 ) suggests opinion leaders obtain critical information from the mass media and, in turn, communicate this information to interpersonal contacts such as friends, family and co‐workers. It is suggested that religious leaders (RLs) may serve as opinion leaders on the topic of organ donation by debunking donation myths, promoting donation during worship services, or communicating the benefit of donation to families faced with the opportunity to participate in living or cadaveric donation. The current study examined the personal knowledge, experiences, and willingness to communicate about organ donation in a sample of RLs (N = 59) in Rochester, New York. Structured interviews were conducted in summer and fall of 2009 with a random sample of RLs. Results indicate a disparity between RLs' expressed personal support for donation and their engagement in donor registration. Approximately one‐quarter of RLs have spoken about donation during a religious service and many indicate their knowledge is not sufficient to discuss organ donation in detail. Results elaborate on how RLs may be trained to serve as opinion leaders in the promotion of organ donation. Copyright © 2010 John Wiley & Sons, Ltd.     

Do the myths still exist? Revisiting people's negative beliefs about organ donation upon death

The prevalence of myths preventing people partial to donation in Australia from consenting is unknown. Respondents (N?=?468: 381 donors, 26 non-donors, 61 undecided) were surveyed about their (negative) donation beliefs. Approximately 30% of donors were neutral or supported negative beliefs about organ allocation, especially donation to undesirable organ recipients and a black market organ trade. Confusion about brain death, lack of family and religious support, and discomfort with donation were negative beliefs endorsed by some respondents irrespective of donor preference. Proportionally, donors had greater trust in hospitals/doctors than other groups. Some myths still exist but may vary with donation preference.     

Inspired to donate: How donors' social class impacts charitable donations

Previous research has found that donors' social class affects their own charitable giving. This research explores the effect of donors' social class on others' donation behavior. Specifically, we propose that individuals feel more inspired to engage in prosocial behavior after learning about low-social-class donors (vs. high-social-class donors) perform the giving behavior. A series of five studies, combining online and experimental data, provide converging support for this proposition and its underlying mechanism of inspiration. Furthermore, we show that the effect of donors' social class on individuals' donation behavior is attenuated when the donation currency is goods (instead of money). The article concludes with implications for the marketing of charities and prosocial behaviors.     

国外器官捐献评估方法介绍

器官移植已成为医学上应用越来越广泛的手段之一。器官移植中器官捐献的分析评估体系作为成熟器官移植系统不可或缺的一部分,能够对器官捐献水平和做出客观的评估,包括捐献潜力,即潜在捐献者率（Potential Donors rate,,PDr）和捐献有效力,即实际捐献者率（Actual Donors rate,ADr）（单位：per million population,pmp）。本文将介绍通过对多国器官捐献评估方法进行分析、总结得出器官捐献中供体评估的主体方法,包括流程、分析方法、适用范围及其积极意义等,希望可以利于我国研究。     

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.     

Examining the Attitude–Behavior Relationship in Prosocial Donation Domains

Positive attitudes have been identified across prosocial donation domains, but have not translated into a stable donor base. One explanation for this attitude‐behavior inconsistency is a failure to consider the affective and cognitive components of attitude. Studies were conducted to examine vested interest as a moderator of the attitude–behavior relationship in donation, while accounting for the multidimensional construction of attitude. Study 1 revealed a 3‐factor structure (stake, salience, self‐efficacy) for vested interest. Study 2 found no support for vested interest as a moderator of the attitude–behavior relationship, but revealed that self‐efficacy mediated the relationship between attitudes and behaviors for organ/tissue and blood donation. Results are discussed in terms of the usefulness of this research in crafting donation campaigns.     

Non-heart-beating organ donation: a reply to Campbell and Weber.

In the preceding commentary, Campbell and Weber raise two valid and important issues concerning non-heart-beating organ donation (NHBOD). First, because the procedure links withdrawal of life support and the potential for subsequent organ donation, the desire for organs may create a situation in which care of the dying individual has relatively less importance and the dying may receive suboptimal care. Second, even if concerns about care of the dying were dealt with adequately, there will not be enough non-heart-beating donors to significantly decrease the organ shortage that exists, making the procedure not worth the risk. We agree that attention to the important details of caring for the dying are, and must be, the primary concern of all health care workers caring for those individuals. Ensuring the patients' comfort, dignity, and autonomy, and providing for family and social support are the mainstays of this care. All policies for NHBOD should clearly support and mandate these concepts. Regarding the second concern, we agree that NHBOD is currently rare; however, evidence is increasing that this type of donation has great potential. Continued growth of the practice in this country will depend largely on public acceptance, which we believe will be directly influenced by whether the public perceives that care of the dying is not compromised by this procedure.     

A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others

Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty’s philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors’ relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine.     

移植协调员在DCD工作中的角色和作用

器官捐献是器官移植事业发展的基石,而协调员在器官捐献工作中则有着举足轻重的地位和作用。自2010年3月我国推行人体器官捐献试点工作以来,适合中国国情的DCD工作成为器官捐献工作的重中之重。如何充分发挥协调员在DCD工作中的作用,提高DCD捐献率和供体转化率,以有效地促进和推动DCD工作,是急待探讨和解决的问题。本文结合...     

善因营销的捐赠水平与消费者态度:一个有中介的调节效应模型检验

通过两个实验,探讨了善因营销的捐赠水平对消费者态度的影响,尤其是考察了道德提升感的中介作用以及产品-公益事业拟合度的调节作用。研究发现,善因营销的捐赠水平对消费者态度有显著的正向影响,且道德提升感在捐赠水平与消费者态度之间起中介作用。与此同时,产品-公益事业拟合度显著地调节了捐赠水平与道德提升感的关系,且该调节关系通过道德提升感的中介作用来进一步影响消费者态度。     

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 Possibilities and Pitfalls of Talking about Conception with Donor Egg: Why Parents Struggle and How Clinicians Can Help

It can be challenging for parents to talk with their children about gamete donation. Many mothers who chose donor egg, following failed fertility treatments and/or advanced maternal age, do not talk about it with their children. Research has found significant parental anxiety, increasing with time after conception, in parents who have not told their children about their donor origins. A set of common reasons given for a reluctance to talk will be considered, along with its impact on the psychic functioning of parents and children. Talking about donor conception is not a one-time conversation but a process that will evolve over the child’s lifetime. Psychological adjustment to the choice of egg donation that can foster disclosure will be discussed, including how couples (1) accept that a donor is required; (2) imagine the donor, who is often anonymous; and (3) incorporate the choice of donor conception into daily family life. There is growing research and psychoanalytic literature on the development of children conceived with gamete donation; however, fewer families of heterosexual parents are included in these follow-up studies because of the prevalence of nondisclosure. This article considers why talking about conception with donor egg is so hard for many families and offers lines of inquiry that may be helpful to these families and the clinicians that will support them.     

Blood donor development: Effects of personality, motivational and situational variables

The present study examined the relative importance of the aversiveness of the donation procedure, donor motives and donor personality characteristics in the blood donors' decision to donate. One hundred and eighty-six blood donors and 106 nondonors took part in this retrospective study. Participants were asked to complete a number of personality measures, and two questionnaires assessing their motives for donating and the aversiveness of their most recent donation experience. Results indicated that both the aversiveness of the donation procedure and the donor's motivation exert considerable influence upon the donors' decision to return and donate again. Additionally, the donors' experience of physical discomfort and fearfulness about the donation procedure made the major contributions to the donation's aversiveness. The results also revealed that significant differences exist among nondonor, ex-donor, irregular and regular donor groups on several personality characteristics, on their motives for donating, and on the components comprising the aversiveness of the donation procedure. A blood donor decision model is presented incorporating the influence of motivational, situational and dispositional factors in the individual's development into a regular donor.     

Discussion of posthumous organ donation in Chinese families

Since family permission is necessary for organ procurement to occur in China, family discussions about posthumous organ donation are crucial for increasing the actual organ donation and transplant rate. However, this study found that among 298 Chinese young adults, most of them (88%) were reluctant to talk about organ donation with their families. Based on the Theory of Reasoned Action, this study investigated communication within families about organ donation. Psychological factors included intention, attitude, subjective norm, death anxiety, and knowledge. As expected, the subjective norm was more powerful than attitude in explaining family discussions among Chinese people. Death anxiety, but not misconception, also significantly lowered the likelihood of family discussion. It is concluded that future campaigns for lessening death anxiety and promoting the social norm for organ donation must be conducted in Chinese societies, in order to encourage family discussions and improve the donation rate.     

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.     

Parental Needs among Children with Birth Defects: Defining a Parent-to-Parent Support Network

The objective of this study was to explore how a parent-to-parent support network could impact parents of a child with a structural birth defect by specifically looking at parents’ continued needs, aspects influencing their participation in support networks, and their recommendations. Structural birth defects occur in approximately 3?% of all infants, representing a significant public health issue. For many reasons, parents are uniquely qualified to provide support to each other. Data were collected retrospectively through a qualitative approach of focus groups or one-on-one interviews. Thirty one parents of infants registered in the Utah Birth Defect Network participated in the study. Three themes emerged, “current sources and inconsistencies in parent-to-parent-support,” “aspects that influence participation in parent-to-parent network,” and “recommendations for a parent-to-parent program.” Health care providers need to be aware of the services and inform parents about these options. A statewide parent-to-parent network integrated into all hospitals would be a valuable resource to facilitate sharing of issues related to caring for an infant or child with a birth defect.     

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.     

Agency,resilience and coping: Exploring the psychosocial effects of goat ownership on orphaned and vulnerable children in Western Kenya

Despite an increase in goat donation programmes geared at orphaned and vulnerable children in sub‐Saharan Africa, the social psychological effects of goat ownership on the lives of these children have yet to be investigated. To shed light on the ways in which goat ownership affects children's psychosocial well‐being, this paper presents a case study of a goat donation programme in Western Kenya, paying particular attention to children's interaction with the goats. Informed by social psychological understandings of resilience and coping, we involved fifteen children (aged 12–17) in this qualitative study, using photographs and written reflections to describe the impact of goat ownership on their lives. The children also created daily routine diagrams and community maps and participated in two group discussions to explore their experiences further. The guardians of two of the participating children were also interviewed. A thematic content analysis of all our data revealed that goat ownership, within this social environment, enabled children to (i) generate income as a result of their participation in goat management, (ii) negotiate social support and (iii) create positive images of self and life – deriving emotional benefits. We conclude that goat ownership provides orphaned and vulnerable children with opportunities for positive social participation and community engagement that can facilitate children's resilience. Copyright © 2011 John Wiley & Sons, Ltd.     

Clarifying the paradigm for the ethics of donation and transplantation: Was 'dead' really so clear before organ donation?

Recent commentaries by Verheijde et al, Evans and Potts suggesting that donation after cardiac death practices routinely violate the dead donor rule are based on flawed presumptions. Cell biology, cardiopulmonary resuscitation, critical care life support technologies, donation and transplantation continue to inform concepts of life and death. The impact of oxygen deprivation to cells, organs and the brain is discussed in relation to death as a biological transition. In the face of advancing organ support and replacement technologies, the reversibility of cardiac arrest is now purely related to the context in which it occurs, in association to the availability and application of support systems to maintain oxygenated circulation. The 'complete and irreversible' lexicon commonly used in death discussions and legal statutes are ambiguous, indefinable and should be replaced by accurate terms. Criticism of controlled DCD on the basis of violating the dead donor rule, where autoresuscitation has not been described beyond 2 minutes, in which life support is withdrawn and CPR is not provided, is not valid. However, any post mortem intervention that re-establishes brain blood flow should be prohibited. In comparison to traditional practice, organ donation has forced the clarification of the diagnostic criteria for death and improved the rigour of the determinations.     

Perish and publish: non-heart-beating organ donation and unduly iterative ethical review

In the expanding repertoire of practices designed to increase the supply of organs for transplantation, non-heart-beating cadaver organ donation has generated an ongoing debate in the literature. The continuing stream of articles is disquieting in part because it documents a troubling "trial-and-error ethics" approach to the formulation of organ procurement policy, and because it raises serious questions about the reasons that the development of this policy is being mediated by published communication. In the light of concerns about the implicit support and credibility that professional publications give to organ procurement policies, restraint in publishing articles about non-heart-beating organ donation as well as in devising such policies is strongly advocated.