Communication Could Increase Organ Donation

July 3, 2001 -- As the numbers of people waiting for organ transplants continues to exceed the number of donors, a new study says better communication could solve a major health crisis.

Fewer than half of families eligible to donate a family member's organs agree to make the donation.

But a study in this week's Journal of the American Medical Association found that who approached a family about organ donation and how they approached the family made a difference in the family's choice. Knowledge that someone could have an open casket funeral even if they donated an organ also increased the likelihood of donation.

Need Outweighs Available Organs

More than 70,000 people waited for donated organs last year, according to the United Network for Organ Sharing. Nearly 50,000 waited for kidneys. Yet, last year the number of donors recovered was 12,000. Only 6,000 of those were recovered from brain dead patients.

In order to understand why people donate organs, researchers examined the death records of more than 11,000 people and spoke with families of those who did and did not donate organs.

Families who thought about organ donation before death and knew or thought they knew the patient's wishes on donation were more likely to agree to donate, the researchers found.

"People don't walk into hospitals with blank slates about this issue," said Laura Siminoff, the lead author of the study and professor of medicine at Case Western Reserve University. "People do have some thoughts and have heard of organ procurement and donation and plantation. They come in with a set of beliefs."

Those beliefs include social, religious and personal beliefs about organ donation, Siminoff said.

"When the process included conversations about donation and the fact that they could choose whether they wanted to donate and that they could still have an open casket they were five times as likely to donate," Siminoff said.

Also, those approached by trained staff members from organ procurement organizations were more likely to donate.

Conversation Worth Having

"Everybody needs to go through this conversation that tells them all about the issues about donating organs, that they can donate anything they do or do not want to donate," said Siminoff.

"They need to know that they can have an open casket funeral if they want, and that donation will not cost them anything. And lastly, we need to call in these people who are specially trained to talk with families about organ donation and we need to do that as early as possible."

Families were unlikely to donate when doctors or other health-care personnel involved in treating the patient assumed they didn't want to donate and made only a superficial request, and when the families' misconceptions and questions were not addressed and answered.

Siminoff said it's vital for family members to know each other's wishes regarding organ donation. Even though a signed organ donor card is legally binding and doesn't require hospitals to obtain families consent to donate, in practice, donations are rarely made without the family being consulted.