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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
Competing interests:
No competing interests
01 June 2007
Roger Jones
Wolfson Professor of General Practice
Myfanwy Morgan
King's College London, 5 Lambeth Walk, London, SE11 6SP
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
Competing interests: No competing interests