Thursday, February 17, 2000
Organ donation opinions diverse
Study finds split along race, age and income lines
BY TIM BONFIELD
The Cincinnati Enquirer
Like most Americans, most Tristate residents say they would like to donate organs after they die.
But wide differences in attitudes about organ donation exist among white and black people, young and old, rich and poor, according to survey results announced today.
These differences may shed light on why so many people endorse the concept, yet so few actually become organ donors. The survey may also help explain why local organ donations declined in 1999 despite expanded efforts to recruit donors.
The organ donation informa tion was collected for LifeCenter, the agency that manages organ donation in the Tristate, as part of a larger local survey on community issues conducted twice a year by the UC Institute for Policy research.
The survey findings come about a week after the LifeCenter announced that the overall number of local organ donors has declined for the second straight year, a trend that has contributed to a 23 percent increase in the waiting list for people who need transplants.
The survey found that 60 percent of Tristate residents as a whole say they are very willing to be organ donors. But less than 50 percent of potential organ donors last year (41 of 88) actually became donors.
Among the most striking details: much less interest in becoming an organ donor among
African-Americans than among whites. Last year, blacks comprised 12 percent of those who agreed to become organ donors, and 27 percent of those who refused.
That news came as no surprise to funeral directors who serve black families.
There's some fear of mutilation of the body. That's a common belief, said Willie R. Donald, co-director of the Donald & Stewart Funeral Home. There's a belief that there will be a getting-up morning (after death) when God comes back. I think some people believe they want all their parts with them when that time comes.
That belief appears rooted more in general cultural attitudes than actual religious teaching.
Few Christian denominations oppose or preach against organ donation, Mr. Donald said. The more commonly held view about the dead rising on Judgment Day is that the faithful will get a new, whole body regardless of what happened to it on Earth.
Aside from faith issues, organ and tissue donations do not mutilate the body in any visible way that would preclude an open-casket funeral, Mr. Donald said.
Objections to organ donation also reflect widespread distrust of the medical system among African-Americans. Memories remain fresh of abuses like the Tuskegee syphilis experiments. Some also fear that white doctors might not work very hard to keep black people alive, especially if a white person is waiting for the organs.
There's a feeling that we have been abused so long and taken advantage of in so many ways that people say, "At least give me some total dignity at death,' said Clarence Glover, director of House of Glover Funeral Services and national president-elect of the Black Funeral Directors and Morticians Association.
The LifeCenter's findings were part of the Fall 1999 Greater Cincinnati Survey, conducted by the UC Institute for Policy Research. More than 1,600 residents in an eight-county region were randomly selected for telephone interviews.
UC conducts the Tristate poll twice a year. Various local agencies pay to add their own questions. This was the first time that LifeCenter has.
The LifeCenter survey found that hesitance about organ donation is not limited to black people. Younger, wealthier, more-educated people were more likely to support the idea of organ donation than older, lower-income, poorly educated people.
Possibly reflecting age-based differences in attitudes, the survey also found that the longest residents of Greater Cincinnati (those living in the same county for more than 20 years) were the least willing to be organ donors. People who are transplants themselves living here less than three years were the most supportive of organ donation.
National surveys also have noted the gap in attitudes about organ donation between whites and minority groups. A 1993 Gallup poll of 6,000 Americans found that 72 percent of whites would likely donate their organs after death compared to 52 percent of blacks.
It may take the passing of a generation to change the quiet discomforts about organ donation, said Mark Sommerville, assistant director at the LifeCenter.
Rather than assume social attitudes will suddenly shift, LifeCenter continues to search for ways to make sure organs get collected from the people who say they want to be donors, Mr. Somerville said.
Beyond the disappointment of a less-than-50-percent consent rate last year, five families refused to give consent even though the person who died had an organ donor sticker on his or her driver's license.
Given that doctors collect three organs from the average donor, the rejec tions from those five families wound up blocking donations that could have saved or improved up to 15 lives.
In some states, such as Pennsylvania, a sticker on a driver's license is considered a legal document. That means a person's organs could be collected even though a surviving family member objects.
In Ohio, organ donor cards are considered legal documents but driver's license stickers are not, Mr. Sommerville said.
The LifeCenter would like to see Ohio change its law on driver's license stickers. But of even higher priority, the LifeCenter would like legal permission to establish a computer donor registry that could be checked whenever hospitals alert the agency about potential donors.
The advantage of a registry is that it could be used to quickly resolve situations in which a dying person had signed an organ donor card but nobody at the hospital can find it. Without the card, families' consent is required, which can result in rejections or delays so long that some organs cannot be used for transplant.
The concerns about a computer registry focus on privacy and patient protection.
Although doctors say it would be a fundamental violation of medical ethics to allow or hasten the death a person because they signed an organ donor card, a computer registry would need a way to protect against even the perception of such a risk, Mr. Sommerville said.
Meanwhile, the LifeCenter plans to expand efforts, such as meeting more often with black church leaders, to ease objections to organ donation among African-Americans. Funeral directors already see small signs of change.
I saw more organ donations last year than I've seen in quite awhile, Mr. Glover said.
We never get involved in asking families to donate organs or body tissues, Mr. Donald said. But I would tell anyone who asks that it's a good thing to do. There will be no mutilation to their loved one. And you are helping pass on life.
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