Brain Death in Asia: Do Public Views Still Influence Organ Donation in the 21st Century?

Liu, Christopher W; Yeo, Charlene; Zhao, Boyu Lu; Lai, Clin K Y; Thankavelautham, Suhitharan; Ho, Vui Kian; Liu, Jean C J

doi:10.1097/tp.0000000000002562

Cited by 9 publications

(6 citation statements)

References 30 publications

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“…However, these findings were similar to the results from surveys on acceptance of BD/DNC by persons from other parts of the developing world: of 593 people in Singapore, only 14% equated BD/DNC with death 33 ; of 123 emigrants from the Dominican Republic to Spain or Florida, 27% understood BD/DNC and accepted it as the death of a person 34 ; of 206 Bolivian emigrants to Spain, 27% understood BD/DNC and accepted it as the death of a person 35 ; and of 1,237 Latin American residents of Spain, 25% understood BD/DNC and accepted it as the death of a person. 36…”

Section: Data On Acceptance Of Bd/dnc In Africasupporting

confidence: 85%

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Lewis

Kumpfbeck

Liebman

et al. 2021

Am J Hosp Palliat Care

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There are varying medical, legal, social, religious and philosophical perspectives about the distinction between life and death. Death can be declared using cardiopulmonary or neurologic criteria throughout much of the world. After solicitation of brain death/death by neurologic criteria (BD/DNC) protocols from contacts around the world, we found that the percentage of countries with BD/DNC protocols is much lower in Africa than other developing regions. We performed an informal review of the literature to identify barriers to declaration of BD/DNC in Africa. We found that there are numerous medical, legal, social and religious barriers to the creation of BD/DNC protocols in Africa including 1) limited number of healthcare facilities, critical care resources and clinicians with relevant expertise; 2) absence of a political and legal framework codifying death; and 3) cultural and religious perspectives that present ideological conflict with the idea of BD/DNC, in particular, and between traditional and Western medicine, in general. Because there are a number of unique barriers to the creation of BD/DNC protocols in Africa, it remains to be seen how the World Brain Death Project, which is intended to create minimum standards for BD/DNC around the world, will impact BD/DNC determination in Africa.

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Section: Data On Acceptance Of Bd/dnc In Africasupporting

confidence: 85%

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Lewis

Kumpfbeck

Liebman

et al. 2021

Am J Hosp Palliat Care

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“…(Details of this methodology have been published elsewhere. 14 For recruitment via community eateries, we visited two popular food halls during the weekday lunch period (12:00–16:00). Trained interviewers then systematically approached each occupied table and invited diners to participate.…”

Section: Methodsmentioning

confidence: 99%

Comparing organ donation decisions for next-of-kin versus the self: results of a national survey

et al. 2021

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ObjectivesIntensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker’s mindset. This focused on: (1) how decisions compare when made on behalf of a relative (vs the self); and (2) confidence in decisions made for family members.DesignCross-sectional survey in Singapore.SettingParticipants were recruited from community settings via door-to-door sampling and community eateries.Participants973 adults who qualified as organ donors in Singapore.ResultsAlthough 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative’s organs. Using machine learning, we found that consistency was predicted by: (1) religion, and (2) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative’s were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives’ wishes on death.ConclusionsThese findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker’s mindset (eg, overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.

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“…(Details of this methodology have been published elsewhere. 14 ) For recruitment via community eateries, we visited two popular food halls during the weekday lunch period (12-4pm). Trained interviewers then systematically approached each occupied table and invited diners to participate.…”

Section: Methodsmentioning

confidence: 99%

“…[7][8][9]12,13 By and large, these factors overlap greatly with those predicting donation choices for the self. 9,14,15 Although this overlap may suggest similarity in the self-versus family-decision making process, it cannot explain the well-documented discrepancy between: (1) high public endorsement of organ donation (for the self), versus (2) low rates of family acceptance (when deciding for next-of-kin). 16,17 Likewise, when participants are surveyed, they report being more willing to donate their organs than a relative's organs 18,19 -a stark drop-off not observed for other death-related procedures (e.g., autopsy).…”

Section: Introductionmentioning

confidence: 99%

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Comparing organ donation decisions for next-of-kin versus the self: Results of a national survey

Liu

Chen

Anwar

et al. 2021

Preprint

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Objectives: Intensive care audits point to family refusal as a major barrier to organ donation. In this study, we sought to understand refusal by accounting for the decision-maker's mindset. This focused on: (1) how decisions compare when made on behalf of a relative (versus the self); and (2) confidence in decisions made for family members. Design: Cross-sectional survey in Singapore. Setting: Participants were recruited from community settings via door-to-door sampling and community eateries. Participants: 973 adults who qualified as organ donors in Singapore. Results: Although 68.1% of participants were willing to donate their own organs, only 51.8% were willing to donate a relative's. Using machine learning, we found that consistency was predicted by: (i) religion, and (ii) fears about organ donation. Conversely, participants who were willing to donate their own organs but not their relative's were less driven by these factors, and may instead have resorted to heuristics in decision-making. Finally, we observed how individuals were overconfident in their decision-making abilities: although 78% had never discussed organ donation with their relatives, the large majority expressed high confidence that they would respect their relatives' wishes upon death. Conclusions: These findings underscore the distinct psychological processes involved when donation decisions are made for family members. Amidst a global shortage of organ donors, addressing the decision-maker's mindset (e.g., overconfidence, the use of heuristics) may be key to actualizing potential donors identified in intensive care units.

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Brain Death in Asia: Do Public Views Still Influence Organ Donation in the 21st Century?

Cited by 9 publications

References 30 publications

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Comparing organ donation decisions for next-of-kin versus the self: results of a national survey

Comparing organ donation decisions for next-of-kin versus the self: Results of a national survey

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