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BMJ 2006;332:1274 (27 May), doi:10.1136/bmj.332.7552.1274
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EDITORBarber et al draw attention to the high refusal rates in the UK as a major reason for poor transplantation rates in the UK, and contrasts these with the Spanish rate for 2004 of 33.0 per million population (comparable figure for 2005 is 35.1/1000 000).1 A similar comparison for the refusal rate may be helpful. The UK transplant team's figure of 41% refusals must be contrasted with an average for Spain of 16.8%, with regional data varying from 9.6% to 30.5%.2
Historically transplantation rates in Spain have been high in areas with a strong regional identity and lower in central rural Spain, although these differences are declining. Anecdotally, one reason for Spain's low refusal rate may be a public belief that organs will be used locally and will therefore benefit people "like the donor." One wonders whether the perception in Britain is that organs may be used at
Graham Brack, community pharmacist
10 Frances Street, Truro TR1 3DN graham.meagher@dnet.co.uk
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