Organ donation seen as much 'sacrifice' as 'gift'

By Anne Harding

NEW YORK (Reuters Health) - Conversations about organ donation with a deceased person's family members need to go beyond the familiar concept of the "gift of life" to address the dark side of organ donation, according to new research involving people who decided against donating a loved one's organs.

Many family members in the study refused donation -- even if they were pro-donation themselves or the deceased person had said they wanted to be an organ donor -- because they feared that the organ retrieval process would be mutilating to their loved one, Dr. Magi Sque of the University of Southampton in the UK and her colleagues found.

In order to encourage more family members to agree to donation, she told Reuters Health, it is essential to address these concerns, which can make the process seem more akin to a sacrifice than a gift.

Organ donation is generally portrayed in a completely "happy, smiling" fashion, the researcher said. "You can find pictures of a heart sort of beautifully wrapped in a gift box." The reality of what families face at a loved one's bedside is, of course, not so sunny, she added.

To better understand why family members frequently refuse donation, Sque and her colleagues interviewed 26 people who declined to donate a family member's organs, and report the findings in the Journal of Advanced Nursing.

Fifteen said that they refused because they felt a need to protect their loved one's body from violation. Many imagined that the surgery to remove the organs would be hasty and brutal, Sque said. "They have very little good knowledge about the fact that the donation operation is something that's done with incredible care, and has to be."

Another obstacle family members may face is that a deceased person being maintained on a ventilator looks very much alive, the researcher added.

Giving the public a clearer sense of this "image of death," as well as what the organ donation process really entails, could help reduce refusals, Sque said.

People who wish to donate their organs should not only discuss this with family members, the researcher advised, but should put their preferences in writing, which can help make it easier for family members to follow through.

SOURCE: Journal of Advanced Nursing, January 2008.