Attitudes towards brain death and conceptions of the body in relation to willingness or reluctance to donate: results of a student survey before and after the German transplantation scandals and legal changes
- 243 Downloads
In Germany, two events regarding organ donation in 2012 happened: media reported about allocation scandals and regulations concerning regular public information were implemented. Public mistrust as a result of the scandals was repeatedly utilized to explain the current decrease in donation rates.
To test for public attitudes towards organ donation, a comprehensive survey with 55 sets of closed questions was conducted twice (2008/09 and 2014/15) with students of medicine and economics (total n = 1403) at the University of Göttingen. Statistical analysis involved a multivariate regression using R 3.2 and focused on potential pre/post-shifts in willingness and on social or attitudinal factors linked with reluctance to donate.
The survey revealed that donation willingness increased (58–75%); in 2014 twice as many held a donor card (24–52%). The majority in both periods agreed that there is a problem of fair allocation (64–74%). Only a small minority considered transplantation well regulated pre- (15%) and post-scandal (11%; p < 0.05 sig.). Analysis of attitudes for reluctance identified non-acceptance of the brain death criterion and sharing a holistic conception of the body linking the human body to personal identity.
Reluctance to donate seems to be linked to deeper cultural attitudes.
KeywordsSurvey Attitudes Organ donation Brain death Germany Scandals
We would like to thank Gitit Bar-On, Klaus Hoeyer, Myfanwy Morgan and Jochem Rieger for comments on an earlier version.
Silke Schicktanz was responsible for planning of the study, conception of survey and analysis, figures, manuscript preparation and finalization. Larissa Pfaller took care of statistical analysis, manuscript preparation and figures, and Solveig L. Hansen was in charge of background analysis of current state of the art technologies, data collection and manuscript preparation. Moritz Boos contributed to statistical analysis and figures.
Compliance with ethical standards
Conflict of interest
All authors state that they do not have any conflict of interest.
This study is part of the research project GZ SCHI 631/7-1 funded by the German Research Foundation.
- Berndt C. (2012) Geld oder Leber. Süddeutsche Zeitung June 16:24Google Scholar
- Deutsche Stiftung Organtransplantation (2016) Statistiken. http://www.dso.de/. Accessed 10 March 2016
- European Commission (2014) Journalist workshop on organ donation and transplantation. Recent facts and figures. http://ec.europa.eu/health/blood_tissues_organs/docs/ev_20141126_factsfigures_en.pdf. Accessed 10 December 2015
- Federal Centre for Health Education (BZgA) (2009) Organ- und Gewebespende. BZgA, Cologne, Germanyhttps://www.organspende-info.de/sites/all/files/files/files/Zusammenfassung_RepBefragung_20Mai09.pdf. Accessed 17 April 2015
- Federal Centre for Health Education (BZgA) (2015) Report on the 2014 Representative Survey “Knowledge, Attitude and Behaviour of the General P.ublic Regarding Organ and Tissue Donation”. https://www.organspende-info.de/sites/all/files/files/files/2015_12/Organ_und_Gewebespende_2014_Ergebnisbericht_EN.pdf. Accessed 17 April 2015
- Inthorn J, Wöhlke S, Schmidt F, Schicktanz S (2014) Impact of gender and professional education on attitudes towards financial incentives for organ donation: results of a survey among 755 students of medicine and economics in Germany. BMC Med Ethics 15:1–8. doi: 10.1186/1472-6939-15-56 CrossRefGoogle Scholar
- Neuberger J, Murphy P (2013) Comment on ‘Lessons from the German Organ Donation Scandal’. JICS 14:201–203Google Scholar
- R Development Core Team (2012) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://cran.r-project.org/doc/manuals/r-patched/fullrefman.pdf. Accessed 20 June 2016
- Repräsentative Befragung der Allgemeinbevölkerung Zusammenfassung. . Accessed 17 April 2015Google Scholar
- Siegmund-Schultze N (2014) Organ donation in Germany: getting out of a tense situation. http://ec.europa.eu/health/blood_tissues_organs/docs/ev_20131007_art21_en.pdf. Accessed 10 December 2015 (English translation of author’s article: (2013) Organspende in Deutschland: Wege aus einer angespannten Situation. Deutsches Ärzteblatt 110:A–2118/B–1872/C–1826)
- Wöhlke S, Inthorn J, Schicktanz S (2016) The role of body concepts for donation willingness: insights from a survey with German medical and economics students. In: Jox RJ, Assadi G, Marckmann G (eds) Organ transplantation in times of donor shortage: challenges and solutions. Springer, Heidelberg, Germany, pp 27–49Google Scholar