Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 152 No. 0102 (2022)

Willingness to donate organs – an anonymised survey in the emergency department 

  • Ksenija Slankamenac
  • Elijah Temperli
  • Dagmar I. Keller
DOI
https://doi.org/10.4414/SMW.2022.w30100
Cite this as:
Swiss Med Wkly. 2022;152:w30100
Published
14.01.2022

Summary

BACKGROUND: In Switzerland, 519 patients received an organ in 2020. In total, 2124 patients were on the donor organ waiting list in 2020. There are many more people who need an organ than people  willing to donate one. Therefore, 43 organs had to be imported from outside of Switzerland and this number was still not sufficient. This disproportion of patients needing an organ and available donor organs is the subject of ongoing discussion. A solution to this problem might be provided by a popular initiative proposing that every single resident of Switzerland should be an organ donor, unless a person explicitly rejects organ donation. We surveyed the patients in a single tertiary care emergency department (ED) to determine whether they had an organ donor card or were registered in the Swiss National Organ Donor Registry (NODR), the frequency of willingness to donate organs and which factors were associated with being an organ donor.

METHODS: In a prospective anonymised survey during July 2019, we enrolled patients who visited a Swiss tertiary care ED, during one week from 8:00 to 18:00, two weeks from 14:00 to 23:00 and one week from 23:00 to 8:00. The patients completed a written, standardised and self-administrated questionnaire during the waiting time in the ED. Descriptive, uni- and multivariable logistic regression analysis were performed.

RESULTS: We enrolled 307 ED patients, of whom 62 (20.2%) were donor card holders or were registered in the Swiss NODR. Of these, 53 (85.5%) would be willing to donate organs. The remaining nine (14.5%) were not willed to donate an organ; the reasons for this were very heterogeneous. In contrast, the two leading reasons for willingness to donate organs were: to help after death (94.3%) and to free relatives from the task of making the decision (43.4%). From the 245 (79.8%) participants who did not have an organ donor card or were not registered, 84 respondents (34.3%) lacked knowledge of this topic, 65 (26.5%) had not yet thought about the topic and 51 (20.8%) had not yet had time to take care of this issue. 

Blood donation (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.1–3.9; p = 0.018) or receiving a transplant in the past (OR 6.1, 95% CI 1.3–29.1; p = 0.023) and having a university degree (OR 1.8, 95% CI 1.0–3.2; p = 0.049) were factors associated with being an organ donor card holder.

CONCLUSIONS: Only one in five ED patients had a fully completed organ donor card or were registered in the Swiss NODR. Of these, the great majority were willing to donate organs. Most of the ED patients who did not have an organ donor card or were not registered in the NODR  lacked knowledge and information about the topic, had not yet thought about it or had not had time to deal with this issue. Factors such as a positive history of blood donation, organ transplantation in the past or having a university degree were associated with having an organ donor card. In order to increase the willingness to donate organs in the future, it is of immense importance to provide better information and more details and knowledge about this important topic.

References

  1. Jahresbericht Swisstransplant. 2020 [cited 2021 Jun 4]. Available from: https://wwwswisstransplantorg/fileadmin/user_upload/Bilder/Home/Swisstransplant/Jahresbericht/Jahresbericht_2020_DEpdf
  2. Swisstransplant. Nationales Organspenderegister. [cited 2021 Jun 4]. Available from: https://registerswisstransplantorg/pages/public/registrationWizardxhtml?lang=de
  3. Bundesamt für Gesundheit BAG [cited 2021 Jun 16]. Available from: https://wwwbagadminch/bag/de/home/medizin-und-forschung/transplantationsmedizin/rechtsetzungsprojekte-in-der-transplantationsmedizin/indirekter-gegenvorschlag-organspende-initiativehtml
  4. Die Bundesversammlung — Das Schweizer Parlament Nationalrat stimmt Paradigmenwechsel bei der Organspende zu, May 05, 2021 [cited 2021 Jun 16]. Available from: https://www.parlament.ch/de/services/news/Seiten/2021/20210505154341785194158159038_bsd139.aspx(last
  5. Nordfalk F, Olejaz M, Jensen AM, Skovgaard LL, Hoeyer K. From motivation to acceptability: a survey of public attitudes towards organ donation in Denmark. Transplant Res. 2016 May;5(1):5. https://doi.org/10.1186/s13737-016-0035-2
  6. Madden S, Collett D, Walton P, Empson K, Forsythe J, Ingham A, et al. The effect on consent rates for deceased organ donation in Wales after the introduction of an opt-out system. Anaesthesia. 2020 Sep;75(9):1146–52. https://doi.org/10.1111/anae.15055
  7. Acitivty Report NH. Organ and Tissue Donation and Transplantation.2020/21 [cited 2021 Sept 14]. Available from: https://nhsbtdbeblobcorewindowsnet/umbraco-assets-corp/23461/activity-report-2020-2021pdf
  8. Gimbel RW, Strosberg MA, Lehrman SE, Gefenas E, Taft F. Presumed consent and other predictors of cadaveric organ donation in Europe. Prog Transplant. 2003 Mar;13(1):17–23. https://doi.org/10.1177/152692480301300104
  9. Johnson EJ, Goldstein D. Medicine. Do defaults save lives? Science. 2003 Nov;302(5649):1338–9. https://doi.org/10.1126/science.1091721
  10. Mossialos E, Costa-Font J, Rudisill C. Does organ donation legislation affect individuals’ willingness to donate their own or their relative’s organs? Evidence from European Union survey data. BMC Health Serv Res. 2008 Feb;8(1):48. https://doi.org/10.1186/1472-6963-8-48
  11. Shepherd L, O’Carroll RE, Ferguson E. An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: a panel study. BMC Med. 2014 Sep;12(1):131. https://doi.org/10.1186/s12916-014-0131-4
  12. Rithalia A, McDaid C, Suekarran S, Myers L, Sowden A. Impact of presumed consent for organ donation on donation rates: a systematic review. BMJ. 2009 Jan;338 jan14 2:a3162. https://doi.org/10.1136/bmj.a3162
  13. Fabre J, Murphy P, Matesanz R. Presumed consent: a distraction in the quest for increasing rates of organ donation. BMJ. 2010 Oct;341 oct18 2:c4973. https://doi.org/10.1136/bmj.c4973
  14. Fabre J. Presumed consent for organ donation: a clinically unnecessary and corrupting influence in medicine and politics. Clin Med (Lond). 2014 Dec;14(6):567–71. https://doi.org/10.7861/clinmedicine.14-6-567
  15. Willis BH, Quigley M. Opt-out organ donation: on evidence and public policy. J R Soc Med. 2014 Feb;107(2):56–60. https://doi.org/10.1177/0141076813507707
  16. McCartney MN. HOLDS BARRED Margaret McCartney: when organ donation isn’t a donation. BMJ. 2017;•••:356.
  17. Molina-Pérez A, Rodríguez-Arias D, Delgado-Rodríguez J, Morgan M, Frunza M, Randhawa G, et al. Public knowledge and attitudes towards consent policies for organ donation in Europe. A systematic review. Transplant Rev (Orlando). 2019 Jan;33(1):1–8. https://doi.org/10.1016/j.trre.2018.09.001
  18. Hansen SL, Eisner MI, Pfaller L, Schicktanz S. “Are You In or Are You Out?!” Moral Appeals to the Public in Organ Donation Poster Campaigns: A Multimodal and Ethical Analysis. Health Commun. 2018 Aug;33(8):1020–34. https://doi.org/10.1080/10410236.2017.1331187
  19. MacKay D. Opt-out and consent. J Med Ethics. 2015 Oct;41(10):832–5. https://doi.org/10.1136/medethics-2015-102775
  20. MacKay D, Robinson A. The Ethics of Organ Donor Registration Policies: Nudges and Respect for Autonomy. Am J Bioeth. 2016 Nov;16(11):3–12. https://doi.org/10.1080/15265161.2016.1222007
  21. Hamm D, Tizzard J. Presumed consent for organ donation. BMJ. 2008 Feb;336(7638):230. https://doi.org/10.1136/bmj.39475.498090.80
  22. Federal Office of Public Health FOPH. Bundesrat und Parlament wollen bei der Organspende die Widerspruchslösung einführen. Available from: https://www.bag.admin.ch/bag/de/home/medizin-und-forschung/transplantationsmedizin/rechtsetzungsprojekte-in-der-transplantationsmedizin/indirekter-gegenvorschlag-organspende-initiative.html

Most read articles by the same author(s)