Tuesday, September 25, 2012

What Inspires People to Become Organ Donors?

What Inspires People to Become Organ Donors?

September 24, 2012

Press Highlights Section Editor: Grace L. Su, MD, University of Michigan Medical School

Story By: Kristine Novak, PhD, Science Editor, AGA Journals

Tax breaks don’t seem to encourage people to become organ donors, but Facebook and opt-out strategies do.

According to American Medical News, since 2004, 16 states have enacted legislation giving living organ donors tax breaks. However these have done little to increase numbers of living organ donors, according to a study by Atheendar S. Venkataramani in last month’s American Journal of Transplantation .

States that approved living-donor tax breaks had a rate of 2.64 donors per 100,000 residents—not significantly better than the rate of 2.47 per 100,000 in states without these tax breaks. So why didn’t the state tax breaks help? It could be that the money to be saved through taxes was not enough to get people’s attention. A family of 4 with the median income in Wisconsin that writes off $10,000 in donation-related expenses would see its actual tax burden fall by only $600, the study said.

Facebook has been making its own attempt to inspire people to become organ donors, campaigning last week to boost organ donations in Canada and Mexico—an expansion of a program that began in the US last May, when Facebook began allowing users to post their organ-donation status on their timeline.

They have encouraged users to tell their friends and family that they registered as organ donors and share stories about how and why they decided to become donors; Facebook provides links to official donor registries. Between May 1 and last week, around 275,000 Facebook users posted their donor status on the site, according NPR’sHealth Blog.

According to Donate Life California—the official organ donor registry in the state—on a normal day around 70 people in California register. In the 24 hours following Facebook's announcement on May 1, almost 4000 registered. However, those numbers came back down just as fast as they shot up. By May 6, the number of Californians registering with Donate Life was back to its usual level. NPR reported that, for social media campaigns like Facebook's to work, people need to be continuously prompted.

Gastroenterology Press Highlights Another strategy to increase the supply of organs is presumed consent. Many European countries have implemented this opt-out policy, which has been successful in increasing the organ supply. According to the LA Times Health Blog, Spain, which has an opt-out policy, has a 35% higher cadaveric organ donation rate than the US, where organs can be procured from decedents only if they registered as organ donors or their next of kin approve (an optin strategy).

The opt-out policy appears to change how people think about the morality of organ donation, said a study published in the 18 Sept issue of Proceedings of the NationalAcademy of Sciences of the United States of America.

Shai Davidai et al. analyzed data from 3 studies and found that ‘opt-in’ vs ‘opt-out’ results in large differences in the meaning that people attach to participation.

They surveyed more than 300 people in the US and Europe and found that those who lived in opt-out countries believed that donating organs after death was not a major ethical issue—they ranked it on a heroism scale somewhere between letting other people go ahead in line and volunteering to work with the poor.

Respondents in opt-in countries like the US, however, ranked organ donation after death as being on par with going on a hunger strike for a cause. According to the LA Times Health Blog, the kind of organ donation program causes people to think about the act of donating in different ways.

Davidai et al. concluded that different default policies influence the meaning that people assign to the act of being an organ donor. More than 115,000 people in the US are waiting for an organ, according to the United Networkfor Organ Sharing. About 80% of these patients need kidneys, which living people can donate with little to no long-term medical ill effects.

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