scholarly journals Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe

2021 ◽  
Author(s):  
Alberto Molina Pérez ◽  
Janet Delgado ◽  
Mihaela Frunza ◽  
Myfanwy Morgan ◽  
Gurch Randhawa ◽  
...  
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Organ Procurement ◽  
Public Knowledge ◽  
The Public ◽  
Organ Retrieval ◽  
Knowledge And Attitudes ◽  
The Family ◽  
Deceased Organ Donation

Goal: To assess public knowledge and attitudes towards the role of the family in deceased organ donation in Europe. Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science. These databases were last searched on December 15th, 2017. Eligibility criteria were empirical studies conducted in Europe from 2008 to 2017 and addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Each record was screened by two or more independent reviewers in three phases. Data collection from each report was performed by two or more independent reviewers. Results: Of the 1,482 results, 467 reports were assessed in full-text form, and 33 were included in this synthesis. Studies show that a majority of the public support the family′s involvement in organ retrieval decision-making and, in particular, their role as surrogate decision-maker when the deceased has expressed no preference. Conclusions: A common conceptual framework and validated well-designed questionnaires are needed to address the role of the family in future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation.

The public debate on organ donation and presumed consent in Denmark: Are the right issues being addressed?

2019 ◽  
Vol 48 (5) ◽  
pp. 480-485 ◽  
Author(s):  
Anja M. B. Jensen ◽  
Johanne Bjørg Larsen
Keyword(s):  
Organ Donation ◽  
Public Support ◽  
Legal Framework ◽  
Public Debate ◽  
Presumed Consent ◽  
The Public ◽  
The Family ◽  
Potential Benefits ◽  
The Right

The legal framework for organ donation in Denmark is informed consent. But due to the unsatisfactory number of organ donors, Denmark is considering changing legislation to presumed consent. This article discusses the public debate on organ donation and presumed consent in Denmark, and asks whether the right issues are being addressed in the quest towards more available organs and better donor rates? Basing our considerations on the various arguments in the debate and on scientific findings, we question the potential benefits of presumed consent and challenge some of the assumptions and rationalizations that characterize the discussions in Denmark regarding public support, public trust and the role of the family in donation decisions.

scholarly journals Opt-out policies capacity to increase organ donors is limited

2021 ◽  
Author(s):  
Alberto Molina Pérez ◽  
David Rodríguez-Arias ◽  
Janet Delgado
Keyword(s):  
Decision Making ◽  
Organ Donation ◽  
Default Rule ◽  
Relative Impact ◽  
Post Mortem ◽  
Presumed Consent ◽  
Organ Retrieval ◽  
Opt Out ◽  
The Family ◽  
The Impact

Objectives: To increase post-mortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. However, studies on the relative impact of opt-in or opt-out on deceased organ donation rates are inconclusive. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the impact of consent policies when considering the role of the family in decision-making. Design: By systematically combining the three components of the decision-making process --the default rule, the deceaseds preferences, and the family s preferences,-- we identify all situations that affect the retrieval outcome under opt-in and opt-out policies. Then, by gathering empirical data from a wide array of countries, we estimate the relative frequency of these situations. Main outcome measures: We measure the relative impact that opt-in and opt-out policies have per se on post-mortem organ retrieval. Results: Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. These policies only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The actual impact of consent policies is typically circumscribed to a range of 0% to 5% of all opportunities for organ retrieval. Conclusions: This study may warn contemporary organ retrieval policymakers that, by emphasizing the need to introduce presumed consent, they might be overestimating the influence of policy defaults and underestimating the power granted to families in expressing their preferences and making decisions about organ donation. Governments should reassess the opportunity and effectiveness of adopting opt-out policies for organ retrieval.

Opt-out paradigms for deceased organ donation are ethically incoherent

2021 ◽  
pp. medethics-2021-107630
Author(s):  
G M Qurashi
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Organ Donor ◽  
Organ Shortage ◽  
Opt Out ◽  
Deceased Organ Donation ◽  
The Dead

The Organ Donation Act 2019 has introduced an opt-out organ donor register in England, meaning that consent to the donation of organs upon death is presumed unless an objection during life was actively expressed. By assessing the rights of the dead over their organs, the sick to those same organs, and the role of consent in their requisition, this paper interrogates whether such paradigms for deceased organ donation are ethically justifiable. Where legal considerations are applicable, I focus on the recent changes in England as a case in point; however, this paper ultimately challenges the justifiability of opt-out systems in any form, concluding that ethical solutions to organ shortage do not lie in opt-out systems of deceased organ procurement.

scholarly journals Improving attitudes toward electroconvulsive therapy

2021 ◽  
pp. 1-7
Author(s):  
Oakley Cheung ◽  
Marc Baker ◽  
Paul Tabraham
Keyword(s):  
Electroconvulsive Therapy ◽  
Perspective Taking ◽  
Medical Information ◽  
Public Information ◽  
Media Representation ◽  
Public Knowledge ◽  
The Public ◽  
Knowledge And Attitudes ◽  
Personal Experiences

Aims and method Electroconvulsive therapy (ECT) often causes fear in the general public because of media representation and negative reported side-effects. This study evaluates a new video focusing on experiences of ECT and how this can aid communicating medical information to the public. Knowledge and attitudes toward ECT after watching the video were compared with a group that received no information and a group that read the current NHS leaflet on ECT. The role of empathy was also considered as a covariate. Results The video was the only condition found to positively affect knowledge and attitudes toward ECT. The video was especially beneficial to those that possessed low perspective-taking trait empathy. Clinical implications These findings demonstrate the video improved knowledge and attitudes toward ECT compared with current material or no information. We suggest that the addition of personal experiences to public information adds perspective, improving overall attitudes toward health treatments.

The role of parents in teenagers' independent decision-making

2020 ◽  
Vol 3 (6) ◽  
pp. 45-47
Author(s):  
Sodiqova Gulbarno Odiljon qizi
Keyword(s):  
Decision Making ◽  
The Family ◽  
Role Of Parents ◽  
Independent Decision

This article provides an overview of the role of parents and parenting methods in teenager independent decision-making in the family, and provides relevant conclusions

Social versus Private Insurance

2018 ◽  
Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre
Keyword(s):  
Social Insurance ◽  
Private Insurance ◽  
Population Ageing ◽  
Fiscal Competition ◽  
Public Insurance ◽  
The Public ◽  
Social Risks ◽  
The Family ◽  
Private And Public

This chapter looks at the role of the public versus the private sector in the provision of insurance against social risks. After having discussed the evolution of the role of the family as support in the first place, the specificity of social insurance is emphasized in opposition to private insurance. Figures show the extent of spending on both private and public insurance and the chapter presents economic reasons to why the latter is more developed than the former. Issues related to moral hazard and adverse selection are addressed. The chapter also discusses somewhat more general arguments supporting social insurance such as population ageing, unemployment, fiscal competition and social dumping.

scholarly journals Accessing the public workforce: Organisational recruitment practices and the inclusion or exclusion of individuals of immigrant origin

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Christine Lang
Keyword(s):  
Decision Making ◽  
Qualitative Case Study ◽  
Ethnic Discrimination ◽  
German State ◽  
The Public ◽  
Ethnic Stereotypes ◽  
Recruitment Practices ◽  
Public Workforce

AbstractOrganisations are important gatekeepers in the labour market inclusion of immigrants and their children. Research has regularly documented ethnic discrimination in hiring decisions. Aiming to further our understanding of the role of organisations in influencing the professional trajectories of individuals of immigrant origin, this paper investigates the recruitment practices of public administrations. Drawing on approaches from organisational sociology and a qualitative case study of public administrations in the German state of Berlin, the article identifies three crucial elements of organisational decision-making affecting the recruitment of staff of immigrant origin: decisions regarding advertisement strategies, formal criteria, and individual candidates. Further, the article shows the underlying decision-making rationalities and the role of organisational contexts and ethnic stereotypes for recruitment-related decisions.

Family perspectives on organ and tissue donation for transplantation: A principlist analysis

2017 ◽  
Vol 25 (8) ◽  
pp. 1041-1050
Author(s):  
Marcelo José dos Santos ◽  
Lydia Feito
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Sao Paulo ◽  
Tissue Donation ◽  
São Paulo ◽  
Ethical Considerations ◽  
Donation Process ◽  
The Family ◽  
Organ Procurement Organizations ◽  
Family Interview

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.

scholarly journals PUBLIC KNOWLEDGE, PRACTICES AND ATTITUDES TOWARDS COVID-19 IN AFGHANISTAN

2020 ◽  
Vol 6 (4) ◽  
pp. 104-115
Author(s):  
Sayeed Naqibullah Orfan ◽  
Abdul Hamid Elmyar
Keyword(s):  
Marital Status ◽  
Online Survey ◽  
Close Contact ◽  
Public Knowledge ◽  
Place Of Residence ◽  
Community Members ◽  
Negative Attitudes ◽  
The Public ◽  
Knowledge And Attitudes ◽  
The Impact

Background: COVID-19 has tremendously affected the world including Afghanistan since its outbreak.Objective: This study aimed to investigate the public knowledge about COVID-19 in Afghanistan as well as practices used to prevent contracting the disease. It also studied the attitudes of the public towards the COVID-19 survivors, and the impact of the participants’ gender, place of residence and marital status on their responses.Method: The data were collected from 1472 individuals through an online survey questionnaire. SPSS version 24.0 was used to analyze the data.Results: The findings showed that the public were very knowledgeable about COVID-19. They used various practices to varying extent to prevent contracting COVID-19 and its spread. Moreover, the participants’ attitudes towards the COVID-19 survivors varied. They had negative attitudes towards them if close contact was concerned, but their attitudes were positive towards them if close contact was not involved, e.g., educating community members about the disease. Gender and place of residence had a significant impact on the participants’ knowledge and practices, but they did not affect their attitudes towards the survivors. Furthermore, marital status significantly affected the participants’ practices, but it did not have any impact on their knowledge and attitudes towards the survivors.

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