Organ supply–demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates.
Methods:
Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs.
Ethical considerations:
The study was approved by the University of Malaya ethics committee.
Results:
The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate.
Conclusion:
Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.
NijkampMDHollestelleMLZeegersMP, et al.To be(come) or not to be(come) an organ donor, that’s the question: a meta-analysis of determinant and intervention studies. Health Psychol Rev2008; 2(1): 20–40.
2.
ReubsaetABrugJNijkampMD, et al.The impact of an organ donation registration information program for high school students in the Netherlands. Soc Sci Med2005; 60(7): 1479–1486.
3.
CantarovichF (ed). Education, a chance to modify organ shortage: a different message to society. Transplant Proc2002; 37: 2511–2512.
4.
SiminoffLABurantCJIbrahimSA. Racial disparities in preferences and perceptions regarding organ donation. J Gen Intern Med2006; 21(9): 995–1000.
5.
CantarovichFCantarovichD. Education and organ donation: “the unfinished symphony.” Transpl Int2012; 25(4): e53–e54.
SharpCRandhawaG. Altruism, gift giving and reciprocity in organ donation: a review of cultural perspectives and challenges of the concepts. Transplant Rev2014; 28(4): 163–168.
12.
HydeMKKnowlesSRWhiteKM. Donating blood and organs: using an extended theory of planned behavior perspective to identify similarities and differences in individual motivations to donate. Health Educ Res2013; 28(6): 1092–1104.
13.
KnowlesS (ed). Using an extended Theory of Planned Behaviour to predict intention towards organ donation. Aust J Psychol2005; 57: 91.
14.
VooTC. Altruism and reward: motivational compatibility in deceased organ donation. Bioethics2015; 29(3): 190–202.
15.
CantarovichF. Organ shortage, are we doing our best?Ann Transplant2004; 9(1): 43–45.
GordonEJKnopfEPhillipsC, et al.Transplant candidates’ perceptions of informed consent for accepting deceased donor organs subjected to intervention research and for participating in posttransplant research. Am J Transplant2020; 20(2): 474–492.
18.
IltisAS (ed). Building norms for organ donation in China: pitfalls and challenges. J Med Philos2019; 45: 640–662.
19.
RiosALopez-NavasAISanchezA, et al. (eds). Multivariate analysis of the factors affecting attitude toward organ donation among the Ecuadorian population residing in Spain. Transplant Proc2018; 50: 2253–2256.
20.
SteenaartECrutzenRde VriesNK (eds). Complexity of organ donation registration: determinants of registration behavior among lower-educated adolescents. Transplant Proc201; 50: 2911–2923.
21.
BalajeeKRamachandranNSubithaL. Awareness and attitudes toward organ donation in rural Puducherry, India. Ann Med Health Sci Res2016; 6(5): 286–290.
22.
Martínez-AlarconLRíosASantainés-BorredáE, et al. (eds). Nursing students’ knowledge about organ donation and transplantation: a Spanish multicenter study. Transplant Proc2019; 51: 3008–3011.
23.
El-ShoubakiHBenerA (eds). Public knowledge and attitudes toward organ donation and transplantation: a cross-cultural study. Transplant Proc2005; 37: 1993–1997.
24.
HydeMKWhiteKM. Perceptions of organ donors and willingness to donate organs upon death: a test of the prototype/willingness model. Death Stud2014; 38(7): 459–464.
25.
LochAHilmiINMazamZ, et al.Differences in attitude towards cadaveric organ donation: observations in a multiracial Malaysian society. Hong Kong J Emerg Med2010; 17(3): 236–243.
26.
MoschellaM. Brain death and organ donation: a crisis of public trust. Christ Bioet2018; 24(2): 133–150.
27.
TuminMNohAJajriI, et al.Factors that hinder organ donation: religio-cultural or lack of information and trust. Exp Clin Transplant2013; 11(3): 207–210.
28.
PhillipsonLLarsen-TruongKPittsL, et al.Knowledge of, beliefs about, and perceived barriers to organ and tissue donation in Serbian, Macedonian, and Greek Orthodox communities in Australia. Prog Transplant2015; 25(1): 91–99.
29.
GerbiABekeleMTesfayeS, et al.Knowledge, attitude, and willingness towards cadaveric organ donation among Jimma University medical centre health care professionals. Transl Res Anatomy2020; 18: 100056.
30.
ToledoJSJrRibeiroEFKCorreiaMM, et al. (eds). Knowledge among university students in Rio de Janeiro regarding transplant organ donation. Transplant Proc2018; 50: 2946–2949.
31.
ZhangQ-XXieJ-FZhouJ-D, et al. (eds). Impact factors and attitudes toward organ donation among transplantation patients and their caregivers in China. Transplant Proc2017; 49: 1975–1981.
32.
ShahMBVilchezVGobleA, et al.Socioeconomic factors as predictors of organ donation. J Surg Res2018; 221: 88–94.
33.
TontusHO (ed). Educate, re-educate, then re-educate: organ donation-centered attitudes should be established in society. Transplant Proc2020; 52: 3–11.
34.
WongboonsinKJindahraPTeerakapibalS. The influence of neighbor effect and urbanization toward organ donation in Thailand. Prog Transplant2018; 28(1): 49–55.
35.
MohandasRCaseyMJCookRL, et al.Racial and socioeconomic disparities in the allocation of expanded criteria donor kidneys. Clin J Am Soc Nephrol2013; 8(12): 2158–2164.
36.
RasiahRManikamRChandarsekaranSK, et al.The influence of socioeconomic and demographic variables on willingness to donate cadaveric human organs in Malaysia. Medicine2014; 93(23): e126.
37.
MossialosECosta-FontJRudisillC. Does organ donation legislation affect individuals’ willingness to donate their own or their relative’s organs? Evidence from European Union survey data. BMC Health Serv Res2008; 8: 48.
38.
WylieMSiddiquiNHazelJ. Organ and tissue donations: Canadian public awareness knowledge and attitudes. Toronto, ON, Canada: Environics Research Group, 2016.
39.
BeardTRKasermanDLSabaRP. Limits to altruism: organ supply and educational expenditures. Contemp Econ Policy2004; 22(4): 433–441.
40.
BennettRSavaniS. Factors influencing the willingness to donate body parts for transplantation. J Health Soc Policy2004; 18(3): 61–85.
41.
KimSJGillJSKnollG, et al.Referral for kidney transplantation in Canadian provinces. J Am Soc Nephrol2019; 30(9): 1708–1721.
42.
PetersTGKitturDSMcGawL, et al.Organ donors and nondonors: an American dilemma. Arch Intern Med1996; 156(21): 2419–2424.
43.
LafitteF.RichardM. Titmuss, The gift relationship: from human blood to social policy, Allen and Unwin, London, 1970. 339 pp. £3.50, paper £1.65. J Soc Policy1972; 1(1): 81–84.
44.
EpsteinRA. Organ transplants: is relying on altruism costing lives. Am Enterp1993; 4(6): 50–57.
45.
SatelSL. When altruism isn’t enough: the case for compensating kidney donors. Washington, DC: AEI Press, 2008.
46.
LaceteraNMacisM. Time for blood: the effect of paid leave legislation on altruistic behavior. J Law Econ Organ2013; 29(6): 1384–1420.
47.
HawleyZLiDSchnierK, et al.Can we increase organ donation by reducing the disincentives? An experimental analysis. Econ Hum Biol2018; 29: 128–137.
48.
KekesJ. Morality and altruism. J Value Inquiry1981; 15(4): 265–278.
SýkoraPWiesingU. Altruism reconsidered: exploring new approaches to property in human tissue. New York: Routledge, 2016.
51.
LaceteraNMacisMStithSS. Removing financial barriers to organ and bone marrow donation: the effect of leave and tax legislation in the U.S. J Health Econ2014; 33: 43–56.
52.
BeloucifS. Opt-in or opt-out for organ transplantation. Curr Opin Anaesthesiol2012; 25(2): 199–203.
53.
LiDHawleyZSchnierK. Increasing organ donation via changes in the default choice or allocation rule. J Health Econ2013; 32(6): 1117–1129.
54.
ChristieB. Scotland plans to move to opt-out system for organ donation. BMJ2017; 358: j3298.
55.
IacobucciG. Proposals for opt-out organ donation launched for England. BMJ2017; 359: j5764.
56.
KaushikJ. Organ transplant and presumed consent: towards an “opting out” system. Indian J Med Ethics2009; 6(3): 149–152.
57.
NoyesJMcLaughlinLMorganK, et al.Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study. BMJ Open2019; 9(4): e025159.
58.
WrightL. Is presumed consent the answer to organ shortages? No. BMJ2007; 334(7603): 1089.
59.
RipponS. How to reverse the organ shortage. J Appl Philos2012; 29(4): 344–358.
60.
ArshadAAndersonBSharifA. Comparison of organ donation and transplantation rates between opt-out and opt-in systems. Kidney Int2019; 95(6): 1453–1460.
61.
ZinkSWertliebS. A study of the presumptive approach to consent for organ donation: a new solution to an old problem. Crit Care Nurse2006; 26(2): 129–136.
62.
BeauchampTLChildressJF. Principles of biomedical ethics. Oxford: Oxford University Press, 2001.
63.
HairJFBlackWCBabinBJ, et al.Multivariate data analysis. Upper Saddle River, NJ: Prentice Hall, 1998.
