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November 25, 1996

Organ Donors and Nondonors: An American Dilemma

Author Affiliations

From the Jacksonville Transplant Center at Methodist Medical Center and the Department of Surgery, University of Florida, Jacksonville (Dr Peters); Department of Surgery, Johns Hopkins University, Baltimore, Md (Dr Kittur); United Network for Organ Sharing, Richmond, Va (Ms McGaw); Division of Nephrology, University of Cincinnati, Cincinnati, Ohio (Dr First); and Department of Surgery, University of Utah, Salt Lake City (Dr Nelson).

Arch Intern Med. 1996;156(21):2419-2424. doi:10.1001/archinte.1996.00440200021003

The principal motive for organ donation in the United States remains altruism. Surveys suggest that if the life-threatening and critical shortage of cadaveric donor organs were appropriately understood by the public, an altruistic response would lead to increased donation. However, despite intense educational efforts appealing to altruism, cadaveric organ donation has not increased substantially while the number of patients in need of a life-saving organ has grown markedly. To understand why organ donation has not increased, a telephone survey and focus group sessions of volunteers who were either for or against donation (donors and nondonors, respectively) were reviewed. The focus group nondonors demonstrated a remarkable lack of trust in the fairness of organ allocation and in the success of transplantation; indeed, this mistrust extended to the entire medical profession. The donors in the focus groups, on the other hand, believed that the system worked equitably, although their knowledge about organ donation and transplantation was equivalent to that of nondonors. For organ donation to increase, efforts must be directed toward those who are not convinced that donation is for the common welfare. One way to increase organ donation is for physicians to educate their patients better regarding the equity and success of transplantation.

Arch Intern Med. 1996;156:2419-2424

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