The Attitude Of Higher Education Students To Compulsory Organ Donation

Introduction

The notion behind organ transplantation is rather simple, remove a healthy organ from a donor, place that organ into a recipient via surgery, connect important tissues, valves and allow the recipient another chance at life (Brezina, 2010). However, it is not that simple in reality, thousands of people wait years at a chance of a new life, while the number of people willing to donate remains stagnant (Brezina, 2010). The task of organ donation is difficult, but with the law changing, it presents the possibility of broadening the general outlook on donation and altering the opinions of students within higher education.

Literature Result

The 1960’s saw historical strides in the way of organ transplants. The first kidney transplant was performed in 1965 in Edinburgh, opening the door for more to be performed throughout the UK (In Wales, 2020). Towards the end of the sixties, the UK’s first heart transplant was performed by a momentous team of eighteen doctors and nurses. Aside from the fact that the UK had now become apart of the vanguard of transplant technologies and surgeries; the structural organisation of donors and their registration became a problem. This introduced the Organ Donation Task Force, it identified the errors which had been holding the organisation back; which were donor identification and referral, donor co-ordination and organ retrieval (Farrell, Price and Quigley, 2011).

Once the issues were rectified and with adequate advertisement for more donors, the donation list saw a gradual positive increase from the year 2010 onwards (Statista,2020). The increase in donors was a cause for correlation, unfortunately the gap between those needing organs and those on the donor list was getting wider, sadly this caused the death of many sick patients (Farrell, Price and Quigley, 2011).

The law of donation before its recent change was referred to as ‘Opt-in’. This means persons were given the choice to opt into voluntarily donating an organ (Taking Organ Transplantation to 2020, 2020) . For a person to qualify as a valid donor they must be over the age of 18, be on the donor register and inform their family (NHS organ donation,2020). In the case of a person being underage and wanting to donate, the final choice would then fall onto the family to provide legal consent (Taking Organ Transplantation to 2020, 2020) . This law has produced success, nevertheless the waiting list for donations began to grow and viable organs are disposed of because adults weren’t donors and/or families don’t consent to donation when approached. According to NHS Blood and Transplant (2020); as of 2020 there are approximately 6175 people who are waiting for an organ donation, with such a large amount of people on the waiting list the healthcare system has been thinking of ways to tackle the ever-rising demand.

Organ shortages isn’t the only problem presented to the task force, there are factors that also contribute to the shortages such as culture, myths and familial influence (Neuberger, Trotter and Stratton, 2017). Myths run rampant within communities; with sayings of ‘doctors won’t take care of me if they know I am an organ donor’, this is morally and legally untrue. It is apart of a doctor’s code of ethics to offer you the best care possible, without doing such they are breaking the oath taken when they became a doctor. Furthermore, donor hospitals aren’t informed that organs are available until after the patient has undergone all provisions to prolong life and when they have been officially pronounced dead (Neuberger, Trotter and Stratton, 2017). It is essential that myths are combatted with the right facts as it is these myths that can prevent a person from donating. As part of the new law the NHS is encouraging conversations where facts combat myths.

According to NHS Organ and Transplant, families present the biggest challenge when it comes to donation. Families are 95% more likely to consent to organ donation if their relative is already on the donation register (Taking Organ Transplantation to 2020, 2020). If the member of their family isn’t on the register they’re 50% less likely to agree to donation says NHS Organ and Transplant (Taking Organ Transplantation to 2020, 2020). This factor reigns important because families are apart of the deciding factors of a person being a valid donor, without their knowledge and consent this validity hangs in the balance. Extending this point, black and ethnic minority families are even less likely to agree to donation, this increases the length of time a patient of these ethnic background needs to wait because those organs are in extremely short supply.

In an effort to combat the shortages, England decided to change the law on organ donation to an ‘Opt-out’ law. This makes every adult in England an automatic organ donor by the time they turn 18. The advantage of this law is that if every person is on the donation as a registered donor, more organs will be able to be supplied to those in need. Though the law may be named Opt-out, this doesn’t take away the rights of the individual, if an individual decides that they don’t want to become a donor they are within their rights to remove themselves from the donor list (NHS,2020). The law also comes with exclusion group which prohibits you from being a donor if you: are under the age of 18, those that lack the mental capacity to understand their decision, visiting England and have lived here for less than 12 months (GOV.UK, 2020)

As the law states that people over the age of 18 will be automatic donors, this leads to evaluating how young people feel about becoming donors. Various articles on the matter report that the consensus amongst most young people is positive. Young people recognise the need for more organs and are interested in hearing the facts surrounding it. According to Burra et al., 2005 young people are more likely to be open to things like organ donation and less likely to believe in mythology. Due to this, people of this age group are more likely to sign up to donor registers if given the proper facts (McNamara et al., 1999). In contrast there are those who are still superstitious and don’t trust that those within the medical field will have their best care in mind. Burra et al., 2005 states that this could be because of mistrust, abuse and lack of faith in the health care system.

Thus arising from this point, students have taken it upon themselves to educate other students on the pros and cons of becoming an organ donor. One main strong point is saving your friends life, many tragedies happen when students are out with friends. Young people are more likely to donate if they know the person, by personalizing organ donation and making it closer to home you’re more likely to effect a change in opinion (House of Lords, P, 2008).

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Methodology

In order to investigate all aspects of this law thoroughly, I began to seek out articles that would include all the necessary details and data for this topic. I used a mixture of qualitative and quantitative data. I began with the NHS Blood and Transplant website, which not only have current statistics and information on the matter, but it also provided past statistics, history and helpful information.

The website clearly outlined the current issues with organ donation and how this affects students within university, it included all factors affecting donation from religion to ethnic shortages, the site was helpful and informative. In addition I used articles that held statistics on the matter also, this allowed a variety of information which I could use to contrast and compare against those of the health institutions. I also gravitated towards government statistics and opinionated websites, it would be a good comparison to mainstream news outlet websites.

Secondly, I relied on books on organ donation and transplantation. The books facilitated in providing further detail that aided my understanding of why England decided to change its laws, also why it’s imperative for people from all different ethnicities to donate and the affect that it is having on those within these communities who are sick. These books and articles highlighted the thoughts of those ethnic minorities and why they felt the reluctance to donate.

Discussion

Reviewing all the data, it is apparent that there is a perception issue when it comes to organ donation. The topic is shrouded in myths, reluctancy and miseducation, although the majority of people know of organ donation, they are only aware of the very basics of the law. To add to this point, black and minority communities are less likely to donate making it difficult for those of that community whom are sick. While it doesn’t completely matter what ethnicity, the organ has come from the organ is less likely to reject if it is from a host that is similar to the patient (Kyriaki et al, 2020).

It was also apparent that patients are more likely to have to resort to treatment while waiting for a transplant, this isn’t a solution rather a temporary fix to try and maintain the sickly organ, this can lead to patients getting sicker and, in most cases dying before getting an organ. This has greatly influenced many families to begin campaigning to the public to increase awareness and knowledge on the situation in England. It is to my understanding that this is one of the reasons the new law ‘Opt-out’ was passed (Kyriaki et al, 2020).

In conclusion it is my opinion that the new change in law will bring the topic of organ donation to more people, getting people talking about it is still positive as some may decide the remain on the donor list whilst coming across some of the information the NHS has posted on its website. Even though there are those young people who don’t look favourably on donating, there are still a generous percentage of youths who believe and support the cause, the future of organ donation rests in their hands.

Findings

The overall findings of this research conclude that England is struggling to meet the demand for organs. Health institutions in the UK have put tremendous efforts in the past and presently to combat stereotypes, myths and mistrust that the public may have towards this topic. Currently 6173 people are on the waiting list for a transplant with only 3200 having received one already, with 3 people dying every day on that list the UK has decided to take a different direction and find a solution to decreasing the number of those waiting. ‘Opt-out’ is the way in which health institutions believe more donations will be made, although some find the law abrasive and believe the government is asserting its rights over peoples bodies, it still brings the topic of donation to the surface and gets people talking, this will encourage people to do their own research instead of relying on myths and misquotes.

The ‘Opt-out’ law does take peoples rights into account as the law doesn’t compel people to be donors and still gives them the option to withdraw consent. The law also has an exclusion list which shows that the law is fair and takes those who are mental impaired into account and doesn’t force them to become donors as they may not understand the magnitude of their decision. Lastly the law still includes familial opinions, it is law that the family has to be notified that a member is a donor.

Finally the law comes with an £18 million contribution to a campaign that encourages families to converse more about donating.

References

1. Brezina, C. (2010). Organ donation. New York: Rosen Pub.
2. Burra, P., De Bona, M., Canova, D., D'Aloiso, M., Germani, G., Rumiati, R., Ermani, M. and Ancona, E. (2005). Changing Attitude to Organ Donation and Transplantation in University Students During the Years of Medical School in Italy. Transplantation Proceedings, 37(2), pp.547-550.
3. Conesa, C., Rios Zambudio, A., Ramirez, P., Canteras, M., del Mar Rodriguez, M. and Parrilla, P. (2015). Socio-personal profile of teenagers opposed to organ donation. [online] Nephrology Dialysis Transplantation. Available at: https://academic.oup.com/ndt/article/19/5/1269/1805777 [Accessed 13 Jan. 2020].
4. Farrell, A., Price, D. and Quigley, M. (2011). Organ shortage. Cambridge: Cambridge University Press.
5. GOV.UK. (2020). Opt-out organ donation: Max and Keira's Bill passed into law. [online] Available at: https://www.gov.uk/government/news/opt-out-organ-donation-max-and-keira-s-bill-passed-into-law [Accessed 15 Jan. 2020].
6. House of Lords, P. (2008). Increasing the supply of donor organs within the European Union. 1st ed. London: TSO.
7. In Wales, H. (2020). NHS at 70 – The History of Organ Donation. [online] Wales.nhs.uk. Available at: http://www.wales.nhs.uk/news/48854 [Accessed 21 Jan. 2020].
8. Kyriaki, P., Chughtai, S., Jean, S. and Khan, S. (2020). [online] Available at: https://journals.lww.com/transplantjournal/Abstract/2018/07001/Attitudes_and_Factors_Affecting_Organ_Donation_in.972.aspx [Accessed 13 Jan. 2020].
9. McNamara, P., Guadagnoli, E., Evanisko, M., Beasley, C., Santiago-Delpin, E., Callender, C. and Christiansen, E. (1999). Correlates of support for organ donation among three ethnic groups. Clinical Transplantation, 13(1), pp.45-50.
10. NHS Blood and Transplant. (2019). A history of donation, transfusion and transplantation. [online] Available at: https://www.nhsbt.nhs.uk/who-we-are/a-history-of-donation-transfusion-and-transplantation/ [Accessed 13 Jan. 2020].
11. UCAS. (2019). Myths about organ donation. [online] Available at: https://www.ucas.com/connect/blogs/myths-about-organ-donation [Accessed 13 Jan. 2020].
12. UPMC HealthBeat. (2020). How Many Lives Can One Organ Donor Affect? | UPMC HealthBeat. [online] Available at: https://share.upmc.com/2015/04/the-impact-of-one-organ-donor/ [Accessed 13 Jan. 2020].