Moderating Role of Religiosity and the Determinants to Attitude, Willingness to Donate and Willingness to Communicate Posthumous Organ Donation Decisions among University Students in Pakistan

Organ transplantation is considered an alternative treatment to save lives or to improve the quality of life and is a successful method for the treatment of patients with end-stage organ diseases. The main objective of the current study was to explore the determinants of the attitudes and willingness to communicate the posthumous organ donation decisions to the families. Questionnaires were used to test the hypothesized relationships. The results confirmed altruism, knowledge, empathy, and self-identity as the antecedents to attitude. We also found perceived behavioral control, moral norms, and attitude as significant antecedents to the willingness to donate organs after death. The results of the study also indicated that those who were willing to sign the donor card were also willing to communicate their decision to their families. Religiosity moderated the relationship between willingness to donate and signing the donor card, and it strengthened the relationship. The findings of this study would provide insight into the factors which can influence posthumous organ donation among university students in Pakistan.

Determinants of Organ Donation Registration Among University Students in Hong Kong

The present study explored the determinants of registration to facilitate the promotion of posthumous organ donation based on the theory of reasoned actions. A total of 211 university students participated in the study. Logistic regression, multiple regressions, and path analysis were conducted. The logistic regression model correctly predicted nearly 80% of registration status, and a good fit model of registration for posthumous organ donation (MRPOD) was proposed. Findings suggested that affective attitude, subjective norm of family, self-rated knowledge, distance from death, and age were predictors of registration. Worries about organ removal and postmortem mutilation anxiety were also mediated through bodily integrity, which had an indirect effect on the registration through affective attitude. Policymakers are suggested to address the negative emotions associated with challenges towards bodily integrity, encourage parents to initiate discussions with children, instill correct knowledge of brain death, and intervene the bystander effect on organ donation.

Normative Aspects of Nudging in the International Sphere

The use of nudges—“low-cost, choice-preserving, behaviorally informed approaches to regulatory problems”—has become quite popular at the national level in the past decade or so. Examples include changing the default concerning employees’ saving for retirement in a bid to encourage such saving; altering the default about consent to posthumous organ donation to increase the supply of organs for transplantation; and informing people about other people's energy consumption to spur them to reduce theirs. Nudges are therefore used to promote the welfare of the people being nudged, and of society at large. However, the use of nudges has sparked a lively normative debate. When turning to the international arena, new arguments for and against nudges can be raised. This essay focuses on the normative aspects of using nudges in the international arena.

Preliminary Development of a Postmortem Bodily Integrity Concerns Scale Among the University Students in Hong Kong

The idea of keeping a body intact has been a major barrier that hinders people from making decision for posthumous organ donation or making consent for their deceased family member. The present research thus attempted to bridge the knowledge gap by conducting an exploratory study to identify the underlying beliefs, and a preliminary validation study to confirm the scale developed thereof. Nineteen university students participated in 5 semistructured focus groups; 115 participated in the exploratory factor analysis, while 96 in the confirmatory factor analysis. An 18-item scale, the Postmortem Bodily Integrity Concerns Scale was developed with 4 subscales: Filial Piety Beliefs, Worries of Organ Removal, Postmortem Mutilation Anxiety, and Detachment to Death. The corresponding measures were established and validated with acceptable psychometric properties and a model of good fit. The findings provided implications for the policymakers to devise plans in dealing with the postmortem bodily integrity issue.

UNDERSTANDING THE ATTITUDES AND FACTORS INFLUENCING ORGAN DONATION DECISIONS AMONG UNIVERSITY STUDENTS IN PAKISTAN: A QUALITATIVE STUDY

Purpose: The main purpose of this study was to identify factors that were important in posthumous organ donation decisions in a developing country such as Pakistan. Methodology: A qualitative study was conducted with 50 semi-structured interviews among students of one public and one private university in Lahore (Pakistan) to understand their attitudes and factors influencing their decisions on posthumous organ donations. Purposive sampling technique was used in this study. The interview questions focused on the level of knowledge, motivation and overall attitude towards the posthumous organ donation decision of the respondents. Main Findings: There was a lack of general knowledge among university students in Pakistan. Most of the students had a positive attitude for posthumous organ donation yet moral norms are very influential in the decision-making process for organ donation after death. Those who were willing were reluctant because of the influence of family and friends. Religion was also another significant norm factor for prohibiting them to be an organ donor after death. Implications/Applications: The present study provided a way in the advancement of knowledge towards an understanding of the attitude, moral norms along with social and family influence for not only intention to donate but also signing the donor card. The findings of the study are useful for the government, policymakers and the organizations in Pakistan in their efforts to increase awareness and organ donation rates in the country. Novelty/Originality: The present research was exploratory and the intention for this research was to explore the underlying behavioral and normative beliefs which may inhibit or encourage organ donation among university students. Such qualitative studies are relatively uncommon in transplant literature.

Egyptians Social Acceptance and Consenting Options for Posthumous Organ Donation. A Cross Sectional Study

Background: Organ donation has become one of the most effective ways in developing and developed countries to save lives and improve the quality of life for patients with end-stage organ failure. No previous studies investigated either the Egyptians’ perception or preferences about different consenting options for organ donation. This study aims to assess Egyptian personal preferences and public perception of norm on several consenting options for posthumous organ donation, and measure the awareness and acceptance of the public to Egyptian law articles regulating organ donation. Methodology: A cross sectional study was conducted along two years among 2743 participants. Participants were chosen from governmental and non-governmental facilities as well as from the general public. Each participant was required to complete the study questionnaire which included demographic characteristics, personal preferences and public norms of eleven consenting options arranged from 1 (most preferred) to 11 (least preferred), and awareness and acceptance of the seven articles of Egyptian laws concerning organ donation. Results: About 78% of the respondents expressed willingness to donate their organs after death while 22% were not willing to donate. Out of donation preferences, informed consent by donor only was a preferable choice, where about one third of respondents assigned to this option the highest ranking scores (31% as a personal preference and 31.6 % for the public norm). There was no difference between males and females or between personal preferences and perception of norms in consenting systems ranking. The awareness for the targeted Egyptian laws regarding organ donation after death was relatively low ranging from 56% to 23%. Conclusion: Informed consent by donor only was the preferable choice as personal preference and as norm. The choice of consenting options did not vary with gender, education or employment. Increasing the awareness of Egyptians on the articles of the law of organ donation is highly needed.