Beruflich Dokumente
Kultur Dokumente
1.1
1.2
1.3
1.4
Subjective norms: These are beliefs that are influenced by the views and expectations of significant others; i.e. family, friends and community.
For example: Since my family has different religious
beliefs from me they won't understand my decision
to donate; people in my community have donated
organs so it must be okay
Perceived behavioural control: How much control
the individual feels they have with regards to carrying out the actual action. For example: It's too
complicated to sign up online.
Figure 1. Taken from The Theory of Planned Behaviour, this illustrates
the relationships thought to exist between these three factors and
a person's intention to carry out a particular behaviour.
BEHAVIORAL
ATTITUDE
SUBJECTIVE
NORMS
INTENTION
BEHAVIOUR
PERCEIVED
BEHAVIOURAL
CONTROL
More specifically, there is much literature concerning the role of faith, spirituality and culture in
organ donation 13, 14, 15, 16. As a result of the existential
nature of organ donation, decisions will accordingly
be influenced by beliefs about life and death.
One study explored the attitudes towards kidney
donation and registering as a donor among ethnic
groups in the UK15. The researchers concluded
that more research is required to understand how
religious and cultural beliefs interact with other
factors, such as self-identification in a minority
group. Similarly, focus groups with members of
Black African and Black Caribbean communities in
the UK highlighted that religion and faith were
potential barriers to becoming an organ donor 17.
Further to acknowledging the role of personal faith
in donation behaviour, it is important to consider
the role of faith and community leaders. Previous
research 18 has found that some faith leaders felt
the need for more education in order to promote
organ and tissue donation. In addition, the term
Faith-placed programmes 19 has been used to refer
to faith based health promotion programmes that
take place in a religious setting or are organized
and operated with the significant involvement of
a faith group. The success of these programmes
is thought to be partly due to the partnership
between faith and secular organisations. Numerous
studies 20, 21 suggest that to be successful, those
implementing health changes through education
programmes should:
to views of life and death, the role of faith and spirituality cannot be ignored. This has been demonstrated through research focusing on BME groups
and specific faith communities.
Through engagement with six focus groups representative of their respective UK faith communities,
the ODC aims to:
Explore faith-based perspectives towards organ
donation to elicit personal attitudes and beliefs
about the views of significant others.
Highlight any barriers to discussion of organ
donation and registration as an organ donor within
different faith communities
Put forward recommendations based on the
findings of the focus groups
(For the purposes of this report, Faith communities refers to Buddhist, Christian, Hindu, Jewish,
Muslim and Sikh groups. These faith groups are
recognised as the dominant faith communities
based on data from the 2001 census; the ODC
recognises that they are not representative of all
UK faith communities).
It is expected that the findings presented in this
report will inform government strategy at a local,
regional and national level by increasing the level
of awareness of organ donation amongst faith
partners and increasing knowledge of religious,
cultural and spiritual perspectives amongst policy
makers and health care professionals.
2.1
2.2
2.3
2.4
2.5
Identifying Stakeholders
Stakeholder Communication
Focus Groups
Data Collection and Analysis
Evaluation
12
14
16
19
21
PUBLIC ENGAGEMENT
There could be formal recognition of the sacrifice made by donors and their families within
the church.
Clergy felt the need to be clearer in their own
views and have the confidence to raise the
questions and issue of death. This could be
achieved through in-house Christian training.
A higher level of general public awareness
through the use of media including celebrity
endorsements and the use of personal stories
to demonstrate the benefits of organ donation.
Clergy could be invited to inform the media
regarding specific religious views and sources
of information. There was a clear request for
the term the message not be used for anything other than the message of Jesus Christ.
The roll-out of education programmes to
increase knowledge of the organ donation crisis.
Reducing society's view of death as a taboo
subject was seen as important.
It was felt to be important that balanced information is provided (i.e possible difficulties
/dilemmas as well as the benefits of organ
donation). It was felt that information that is
not balanced would be viewed as Department
of Health propaganda.
Personal Influences
A lack of trust in the system of organ donation was
discussed. Questions raised included who would
receive donated organs (whether they would be
sold to rich people or go to people from other
countries) and whether organs would be wasted.
They recognised the impact of media on people's
lives and health decisions and thought that this
could be utilised to greater effect.
Religious Influences
Particular religious beliefs such as compassion
deya, karma, daan and the idea that it was
insikhi not to give were discussed. As mentioned
above, there was a recurrent theme of the body
as a vessel for the soul, and at the point of death
there is detachment of the soul from the physical
world. They reported that talking about death is
part of the code of conduct, so they felt that
there were no specific religious barriers in relation
to this. They mentioned that there could be general
concerns from community members around the
physical appearance of the body at the time of the
funeral and interference with the traditional funeral
timeline.
However, the representatives felt that the
interaction between the process of organ donation
and the religious requirements at death and
afterwards could easily be clarified. The theme of
choice over organ recipient was raised and the
possibility that their communities may feel
uncomfortable about their organs going to nonSikhs or to other people, i.e. those who did not
follow the same religious practices.
Culture specific information: The group members recommended that the dissemination of
public information aim to be more inclusive of
people from BME communities and culturally
specific. They recommended the use of images
that are specific to the Sikh religion and Punjabi
culture.
Culture specific media should be used, such as
Punjabi radio, television channels and websites.
The group stressed the importance of targeting
different generations using appropriate
methods.
The group requested that consultation is sought
about how Sikh religious teachings are quoted
in written material to avoid giving offence.
Education efforts to focus on the specific
cultural concerns of the process of donation.
organ donation. There were mixed responses concerning the level of confidence felt when offering
guidance. One representative reported feeling
confident in endorsing organ donation and explaining their particular stance. Another representative
felt they were able to guide exploration of the
debate but not prepared to advise an individual in
either direction. The majority reported that they
did not feel confident and would generally direct
members of their communities to more knowledgeable information providers such as scholars, local
mosques or other institutions of Islamic learning.
3.3.3 Cultural, Religious and Personal Influences
Cultural influences
Representatives reported prior negative experiences with healthcare professionals including poor
communication and cultural insensitivity.
Religious Influences
Representatives discussed the presence of confusion about the faith's position on organ donation.
They questioned whether the dignity of the dying
person would be compromised by the donation
process and importantly, whether the process
would interfere with the need for Muslims to bury
the recently deceased as soon as possible. There
was detailed discussion about the sanctity of the
body, mutilation and whether it is important for
the body to remain whole for the hereafter. The
important philosophical, legal, moral and ethical
question of Who owns the body? was also raised.
Knowing that organs may go to non-Muslims was
seen as a critical factor in informing an individual's
decision regarding donation. In relation to this,
one person stated that if it was known that other
Muslims would be the recipients of Muslim organs,
there may be less ambivalence about donating.
Personal Influences
A high level of mistrust of the NHS in general and
of individual clinicians was expressed by many
participants. There were concerns about the standard of medical treatment received if it was known
that their organs were going to be donated after
death. There was a fear of the body being disrespected by clinicians throughout the process of
donation. This was a particularly troubling issue,
as clinicians may not share the same religious values
and patient trust may be compromised.
Representatives reported that it is difficult for
families to think about their loved ones bodies
being interfered with after death.
3.3.4 Future Directions
DEVELOPING TRUST AND TRANSPARENCY
PUBLIC ENGAGEMENT
PUBLIC ENGAGEMENT
There was a request that more detailed information about the process of organ donation
be published. This should include clear statistics
and information to dispel myths (such as eligibility of homosexual men in donating organs).
Group members requested clear and detailed
information on the medical process of retrieving organs after death. They requested that
the public be informed about what happens
to organs in the event that they are not used
for donation. This level of honesty in the inforZmation available would increase people's trust
in the medical system, diminish religious
barriers and eliminate myths.
Recommendations were made about how this
information could be publicised. Group members pointed out that different generations
access information using different methods,
thus the use of various mediums should be
explored.
PUBLIC ENGAGEMENT
PUBLIC ENGAGEMENT
with the aid of a ventilator. The halachic understanding of death is cardio-respiratory-it occurs
when the heart stops beating and breathing ceases.
Therefore, to remove an organ under the medical
definition could mean that an organ is being
removed from someone who is considered to be
still alive. Members were keen to note that the
issue is death, not organ donation. Live donation,
however, was seen as a less complex issue as it
does not involve this dilemma. With live donation,
there was a discussion around the ethics of buying
and selling organs. Some felt that this would be
unethical while others did not. All agreed that it
would not be permitted to buy and sell organs from
the dead as this would violate the law of CavodHamed. The group acknowledged the view of some
schools of thought focus on the need for the body
to be buried whole. It was reported that some
religious authorities have clearly said that it is not
necessary for the body to be buried whole. In the
case of any type of donation, it would need to be
known for a fact that the organ would be used
immediately to save a life.
3.6.2 Role of faith representatives
The faith representatives all agreed that there
would be varied responses from different Rabbis
and that responses from one Rabbi could vary,
depending with whom that Rabbi was speaking.
There was some discussion about the importance
of getting advice about organ donation from a faith
perspective. In most cases, individuals would
consult their own Rabbi who would usually direct
them to another Rabbi with specialist knowledge
of organ donation or medical ethics or refer to a
Dayan. One group member shared an instance
when they had been asked their views on organ
donation in their capacity as a teacher. They did
not feel able to advise the individual and emphasised the need to seek advice from a Rabbi.
Representatives felt that individuals who chose to
donate their organs, even in the presence of the
current confusion, should not feel guilty about it
and that there should be no recriminations from
the community.
Organ Donor Campaign 21
PUBLIC ENGAGEMENT
4.1
4.2
4.3
4.4
BUDDHIST
_ No specific recommendations
_ Concerns were raised about the lack of honest
and detailed information about the donation
process.
CHRISTIAN
HINDU
_ No specific recommendations
_ Concerns were raised about not receiving
feedback from previous involvement.
MUSLIM
_ No specific recommendations
_ Concerns were raised about mistrust of the
medical system and of individual health
professionals due to previous negative
experiences.
SIKH
_ No specific recommendations
_ Concerns were raised about previous
involvement due to feeling unheard.
_ Concerns were raised about a lack of trust
around organs being misused or wasted.
This is seen as a possible barrier.
JEWISH
Public Engagement
_ Self-appointed organ donor champions within
communities
_ Organ donation could be subject of dharma
talk
_ Increase dialogue within practice groups and
across different traditions
CHRISTIAN
HINDU
MUSLIM
SIKH
JEWISH
CHRISTIAN
HINDU
MUSLIM
SIKH
JEWISH
Process of registration
_ Levels of permission when registering e.g.
organs used for research
_ In the signing up process, to have a prompt
about whether or not issue has been discussed
with family or significant others
CHRISTIAN
HINDU
MUSLIM
SIKH
_ No specific recommendations.
JEWISH
18. Arriola, K, R, J., Perryman, J.P., Doldren, M.A., Warren, C.M &
Robinson, D.H.Z (2007). Understanding the Role of Clergy in African
American Organ and Tissue Donation Decision-Making. Ethnicity
and Health, 12 (5), 465-482.
19. Yanek LR, Becker DM, Moy TF et al. (2001) Project Joy: faithbased cardiovascular health promotion for African-American women.
Public Health Rep, 116 ( 1), 68-81.
Q1
Christian
Organisation 1
Christian
Organisation 2
Christian
Organisation 3
Christian
Organisation 4
Sacrifice &
neighbourly love
Neighbourly love
Neighbourly love
Nothing that
prohibits organ
donation
Resurrection of the
body therefore do
not need old one
Christian
Organisation 5
Q2
Religious
Love of neighbour
Love and sacrifice
Compassion
Compassion
Healing
Giving
Personal
Process of
retrieving organs
and distress to
family
No
Myths
More education
Education for the
churches
Psychological reaction
against organ donation
Family distress
Knowledge about
process of organ
retrieval
The importance of
Christian teaching to the
individual
Cultural
No Cultural
Q3
Definition of death
People unaware
Education at
community level
Church-based
publicity campaigns
Lack of information
provision and
support for the
family at a time of
shock.
Access to a chaplain
Hindu Organisation
Overall it was reported that Hindu scriptures do not prohibit organ donation
and as the soul is reincarnated, the body can be used for the benefit of others.
It was emphasised that the Hindu Council had issued a statement endorsing
organ donation and that this organisation recommends that people of the
Hindu faith carry organ donor cards
Organ Donor Campaign 32