The complexity of organ donation: A review of the literature
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This thesis seeks to better understand the factors involved in facilitating or impeding people’s desires to register as organ donors. Through an examination of existing literature on the subject it examines issues of altruism, religious beliefs, and trust in the systems responsible for organ donation and transplantation. The thesis also considers the different perspectives offered on these topics by the quantitative and qualitative literatures on these subjects. While increasing education of organ donation and transplantation a primary focus in both literatures, this focus overlooks how factors besides people’s knowledge of transplantation impacts the decisions they make. Religion is another factor that is often studied. All major religions accept donation practices, but many individuals cite religious beliefs as reasons not to donate. Likewise, altruism is identified as the biggest perceived benefit of donation, and medical mistrust is a major reason many choose not to donate despite adequate knowledge of donation and its benefits. Within the qualitative literature, narratives from surgeons, donor families, and recipients provide unique insights into these issues that are largely absent in the quantitative literature. Ultimately, this thesis finds that transplantation, and especially the quantitative research on this subject, is heavily skewed by the worldview of biomedicine, one that views the body as a machine with replaceable parts that can be fixed. In order to increase organ donation rates, especially in communities that lack trust in the medical field, systematic change is needed. To accomplish this those that lead organ donation efforts must first recognize the underlying issues that prevent organ donation and then work to make changes to the system so that those issues are appropriately addressed and mitigated.