Louisiana neurosurgeons and the organ procurement shortage: a comparative analysis of perceptions, attitudes, and ethical values.

The supply of transplantable organs continues to fall behind demand. Knowledge of the perceptions, attitudes, and ethical values held by health care workers involved in the process is critical. This is particularly true of neurosurgeons because of their pivotal role in the procurement process. Survey data are used to compare neurosurgeons (n = 59) with emergency physicians (n = 125), critical care nurses (n = 267), and other physicians (n = 445). Analysis revealed that attitudes among those health care workers regularly involved with organ procurement and transplantation--neurosurgeons, emergency physicians and critical care nurses--tend to be similar. While there is general satisfaction and confidence in Louisiana's organ procurement and transplantation system, there are concerns. Perceived problems cited were: lack of support by the medical and lay community, high costs, potential profiteering, and conflict of interest. Other contentious issues include: organ request strategies, incentives for organ donations, racial bias, and presumed consent legislation. Debate and professional education in these areas are indicated.