Changing attitudes, improving lives
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l1026 (Published 07 March 2019) Cite this as: BMJ 2019;364:l1026All rapid responses
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We fully support the view that strategies to improve education and public awareness to change attitudes to organ donation is key.
Erin Walker eloquently describes how the privilege of receiving an organ transplant has allowed her to experience and enjoy many of life's rites of passage. She treats her recipient organs, and therefore the donors, with respect by honouring 'transplant anniversaries'. And they in turn are present at, and share in, her significant life events.
Remembering them in this way shows us that organ donation is not simply a transactional give/take process: the donor can be thought of as taking on the role of 'guardian' for someone in need. They might become a guardian of the heartbeat, a guardian of the breath, a guardian of the water or a guardian of sight. Whereas others leave and live on only in the memories of those who knew them, the guardian donor chooses to remain and lives on in this world.
The opt-out system may or may not increase the number of organs available for transplantation, but the main intent (and benefit) would be to allow greater opportunity for life, love & happiness - for oneself after death.
Competing interests: No competing interests
How to change attitudes when we have different plans?
Oncologists are constantly trying to test new therapies in the treatment of cancer, so they always offer new protocols to their patients even for those who need to go into palliative care.
When the patient is aware of the details of the progression of his illness and able to decide, the task of the doctor becomes easier. How to discuss palliative care or organ donation with patients and parents is one of the communication techniques that physicians must learn and apply.
However, awareness and education of the population is continually required that it is through campaigns outside hospitals or within the walls of hospitals. Thus, patients and their families do not feel offended once the subject of palliative care or organ donation is proposed.
It is a matter of educating the population and training the doctors.
Grace Abi Rizk
Associate professor
Saint Joseph University
Lebanon
Competing interests: No competing interests
Of the few situations in medical practice , ill understood or misunderstood and poorly comprehended / interpreted , both by patients / attending relatives and often by medical fraternity members themselves are the twosome - palliative care and EoLC (end of life care ). Conventionally trained to do the best till the 'last' , anything 'less' or 'withdrawl in some form - drugs , devices , equipment ' may be construed as compromise ,retreat , surrender and defeat , often with a feeling of apprehension and guilt. The decision has to be clinically dictated , situationally considered and ascertianed , adequately counselled. Expectations of improvement , posotive outcome and recovery from the patient and relatives can be unrealistic , what with medical feats appearing regularly in the lay media. Finally humanity survives on hope and doctors need to know that hopes in the worst clinical scenarios can be 'eternal '. Rebranding may not be a wise step to undertake ; clarity of concepts for both the sides , sound understanding , correctness on timing of the clinical decision to palliative care and overall social approval appear to be prerequisites necessary for making life and survival bearable and the inevitable acceptable. Dr Murar Yeolekar, Mumbai.
Competing interests: No competing interests
Re: Changing attitudes, improving lives
We found an interesting contrast between the difficulties in the uptake of palliative care services and the worrying appeal of vaping in teenagers in the US[1]. The latter being a habit which is clearly harmful compared with services which aim to improve the quality of life of patients. It is clear that influencing people's perceptions can have a huge impact on their behaviour.
It seems that the blunt marketing techniques used by Juul regarding the harmful nature of their product, and their statement that 'no young person should ever try our product' are actually working in their favour and probably in fact making it all the more appealing for young people because of their perceptions of what is 'cool'. This is no doubt the result of some very clever branding strategies which may be worth exploring to help solve the branding problem and negative perceptions associated with palliative care services. If advertisers can sell death so easily then surely, with similar marketing expertise, services to improve quality of life should be an easy sell. Perhaps the solution could be to consult branding and marketing experts such as these to develop strategies to change perceptions of patients and relatives when it comes to palliative care services.
1. BMJ 2019;364:l979
Competing interests: No competing interests