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FEATURE: Linda Wright Is presumed consent the answer to organ shortages? No BMJ 2007; 334: 1089 [Full text]

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Shortage of donor organs: the cultural dimensions

Roger Jones, Myfanwy Morgan   (1 June 2007)

Shortage of donor organs: the cultural dimensions 1 June 2007
Roger Jones, Wolfson Professor of General Practice King's College London, 5 Lambeth Walk, London, SE11 6SP, Myfanwy Morgan Send response to journal: Re: Shortage of donor organs: the cultural dimensions	In the debate on the use of presumed consent as an answer to dealing with the shortages of donor organs, Linda Wright briefly makes the important point that many countries are multi-cultural societies, so that the potential pool of organ donors should not be regarded as ethnically, culturally or in any other way homogeneous. In the UK rates of end-stage renal failure requiring renal replacement therapy with organ transplantation among Black African and Caribbean and Asian patients is rising at a rate which is disproportionate to the numbers of organs donated for transplantation by the same cultural groups.1 Approximately 22% of patients awaiting renal transplantation are from so-called ethnic minority groups, whilst only 3% of cadaveric kidney donors are from these groups. In a recent population-based study we have shown systematic differences in attitudes towards organ donation held by African Caribbean and Asian subjects,2 which are reflected in varying degrees of mistrust of the medical profession, concerns about the way that bodies are handled after death and spiritual and religious beliefs about the unity of body and soul. Our further research has indicated a high degree of disaffection and alienation amongst some ethnic groups living in the UK which, combined with very different cultural beliefs about the disposal of the body after death, mean that a range of ‘culturally sensitive’ approaches to improving organ donation rates is required, rather than a single, undifferentiated campaign. We need more information before we can confidently launch further public awareness campaigns or to provide useful information about organ failure and organ donation. We also need to be better informed about the most appropriate ways of approaching individuals and families about the possibility of dying relatives’ organs being used for transplantation or of considering living organ donation. A substantial research effort in this area is urgently required. 1. Barber K, Falvey S, Hamilton C, Collett D, Rudge C. Potential for organ donation in the United Kingdom: audit of intensive care records. Brit Med J 2006; doi:10.1136/bmj.38804.658183.55 2. Morgan M, Hooper R, Mayblin M, Jones R. Attitudes to kidney donation and registering as a donor among ethnic groups in the UK. Journal of Public Health 2006; 38; 226-234 Competing interests: None declared