TY - JOUR
T1 - Enforcement of presumed-consent policy and willingness to donate organs as identified in the European Union Survey
T2 - The role of legislation in reinforcing ideology in pluralistic societies
AU - Verheijde, Joseph L.
AU - Rady, Mohamed Y.
AU - McGregor, Joan
AU - Friederich-Murray, Catherine
PY - 2009/4
Y1 - 2009/4
N2 - To increase the supply of transplantable organs, some European Union (EU) countries have begun implementing and enforcing presumed consent policies for organ donation. Mossialos and colleagues performed an analysis of samples of citizens in 15 EU countries and found that legislation, enforcement, and awareness of presumed consent policies for organ donation increase people's willingness to donate their own organs and those of a deceased relative. The authors concluded that, in countries with enforced presumed consent, citizens are willing to donate because they accept organ donation as an ideology. This ideology originates in the thinking that organ donation is an implicit communal contract i.e., a mechanism by which individuals pay back society for the inclusion and social support that they have already experienced and hope to experience in the future. Acceptance of this ideology enhances people's willingness to donate organs and the efficiency in pursuing this collective action, thus, paving the way toward increased paternalism in society. We highlight some potential biases that may have been incorporated in the survey design and in Mossialos et al.'s conclusions, including (1) how the survey questions were constructed, (2) whether sufficient information was communicated about organ procurement practices in heart-beating and non-heart-beating donation before participants responded to the survey, and (3) whether respondents' knowledge about donation legislation can be equated with understanding of processes involved in organ donation. We address the consequences of using legislative authority to enforce the ideology of organ donation, thereby superseding the varying moral values, beliefs, and attitudes about human life and culture that are inherent in multicultural societies.
AB - To increase the supply of transplantable organs, some European Union (EU) countries have begun implementing and enforcing presumed consent policies for organ donation. Mossialos and colleagues performed an analysis of samples of citizens in 15 EU countries and found that legislation, enforcement, and awareness of presumed consent policies for organ donation increase people's willingness to donate their own organs and those of a deceased relative. The authors concluded that, in countries with enforced presumed consent, citizens are willing to donate because they accept organ donation as an ideology. This ideology originates in the thinking that organ donation is an implicit communal contract i.e., a mechanism by which individuals pay back society for the inclusion and social support that they have already experienced and hope to experience in the future. Acceptance of this ideology enhances people's willingness to donate organs and the efficiency in pursuing this collective action, thus, paving the way toward increased paternalism in society. We highlight some potential biases that may have been incorporated in the survey design and in Mossialos et al.'s conclusions, including (1) how the survey questions were constructed, (2) whether sufficient information was communicated about organ procurement practices in heart-beating and non-heart-beating donation before participants responded to the survey, and (3) whether respondents' knowledge about donation legislation can be equated with understanding of processes involved in organ donation. We address the consequences of using legislative authority to enforce the ideology of organ donation, thereby superseding the varying moral values, beliefs, and attitudes about human life and culture that are inherent in multicultural societies.
KW - European Union
KW - Health policy
KW - Ideology
KW - Legislation
KW - Medical
KW - Organ donation
KW - Organ procurement
KW - Organ transplantation
KW - Presumed consent
UR - http://www.scopus.com/inward/record.url?scp=62249132204&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=62249132204&partnerID=8YFLogxK
U2 - 10.1016/j.healthpol.2008.08.008
DO - 10.1016/j.healthpol.2008.08.008
M3 - Article
C2 - 18845356
AN - SCOPUS:62249132204
SN - 0168-8510
VL - 90
SP - 26
EP - 31
JO - Health Policy
JF - Health Policy
IS - 1
ER -