Nordfalk Francisca, Olejaz Maria, Jensen Anja M B, Skovgaard Lea Larsen, Hoeyer Klaus
Department of Public Health, Section for Health Services Research, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, DK 1014 Denmark.
Transplant Res. 2016 May 23;5:5. doi: 10.1186/s13737-016-0035-2. eCollection 2016.
Over the past three decades, public attitudes to organ donation have been a subject of numerous studies focusing on donor motivation. Here, we present a fresh approach. We suggest focusing on public acceptability instead of motivation. The point is to understand public attitudes well enough to avoid risking public support for organ transplantation. We conducted the study in Denmark because there have been significant developments in public attitudes to organ donation in this country. In the 1990s, Denmark was a country with very low public support for organ donation and Denmark was the last country in Europe to introduce brain death as a legal criterion of death, whereas today Eurobarometer surveys rate Denmark as one of the European countries with the highest support for deceased organ donation from brain dead donors.
We conducted a telephone survey in Denmark (N = 1195). A questionnaire was developed on the basis of preceding qualitative studies and pilot testing and included reuse of one item from earlier surveys to facilitate historical comparison. The analysis of the data was carried out using IBM SPSS Statistics 22 and focused on descriptive statistics.
A clear majority of 91.9 % are positive or very positive towards organ donation; 85.8 % like the idea of their body being used after their death, 85.0 % is willing to donate their own organs, 82.1 % to donate their tissue and only 2.3 % find that too much has been done to promote organ donation. There is limited support for monetary incentives for organ donation (5.8 %) and presumed consent (30.4 %), while a majority (63.9 %) supports making it mandatory to register a personal decision. Religious self-identification has limited impact on attitudes.
We can identify a shift over the past three decades from marked opposition to organ transplantation to strong support as well as a pattern in the contemporary public attitudes, which can help explain what is central to public acceptability: self-determination. Policies fostering choice are met with a majority of positive attitudes, while presumed consent and monetary incentives are met with more negative attitudes. Our approach calls for comparative studies in other countries to generate a better overall understanding of the conditions of acceptability, which need to be in place to ensure the long-term social robustness of organ donation and thereby safeguard this important medical technology.
在过去三十年里，公众对器官捐赠的态度一直是众多聚焦捐赠者动机研究的主题。在此，我们提出一种新方法。我们建议关注公众的可接受性而非动机。关键在于充分了解公众态度，以避免危及公众对器官移植的支持。我们在丹麦开展这项研究，因为该国公众对器官捐赠的态度有了显著变化。在20世纪90年代，丹麦公众对器官捐赠的支持率很低，丹麦是欧洲最后一个将脑死亡作为法定死亡标准的国家，而如今欧洲晴雨表调查将丹麦列为对脑死亡者器官捐赠支持率最高的欧洲国家之一。
我们在丹麦进行了一项电话调查（N = 1195）。基于之前的定性研究和预测试编制了一份问卷，其中包含重复使用早期调查中的一个项目以方便进行历史比较。使用IBM SPSS Statistics 22对数据进行分析，重点是描述性统计。
高达91.9%的绝大多数人对器官捐赠持积极或非常积极的态度；85.8%的人赞成死后自己的身体被利用，85.0%的人愿意捐赠自己的器官，82.1%的人愿意捐赠自己的组织，只有2.3%的人认为在促进器官捐赠方面做得过头了。对器官捐赠给予金钱激励（5.8%）和推定同意（30.4%）的支持有限，而大多数人（63.9%）支持强制登记个人决定。宗教自我认同对态度的影响有限。
我们可以确定，在过去三十年里，公众态度已从对器官移植的明显反对转变为大力支持，同时当代公众态度呈现出一种模式，这有助于解释公众可接受性的核心要素：自决权。促进选择的政策得到大多数人的积极态度回应，而推定同意和金钱激励则得到更多负面态度回应。我们的方法呼吁在其他国家开展比较研究，以更好地全面了解可接受性的条件，这些条件对于确保器官捐赠的长期社会稳健性从而保障这项重要医疗技术至关重要
