Evaluation of the law of presumed consent after brain death by Spanish journalism students

Public Perception of Organ Donation and Transplantation Policies in Southern Spain

BACKGROUND

This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation.

MATERIALS AND METHODS

A representative sample of 813 people residing in Andalusia (Southern Spain) were surveyed by telephone or via Internet between October and December 2018.

RESULTS

Most participants trust Spain's donation and transplantation system (93%) and wish to donate their organs after death (76%). Among donors, a majority have expressed their consent (59%), and few nondonors have expressed their refusal (14%). Only a minority are aware of the presumed consent system in force (28%) and feel sufficiently informed regarding the requirements needed to be an organ donor (16%). Participants mainly consider that relatives should represent the deceased's preferences and be consulted when the deceased's wishes are unknown, as is the case in Spain.

CONCLUSION

Public trust in the transplant system may contribute to Spain's high performance in organ donation. High levels of societal support toward organ donation and transplantation do not correspond with similar levels of public awareness of donation and transplantation policies in Spain.

Organ Donation Related With Attitude Toward the Law of Presumed Consent: Spanish University Medical and Nursing Students Study

INTRODUCTION

Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the general public is essential to obtain organs.

OBJECTIVE

To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT.

METHODS

and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish [PCID-DTO-RIOS]) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study.

RESULTS

Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001). Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000).

CONCLUSION

Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.

Veterinary Spanish Students' Attitude Toward Presumed Consent in Organ Donation

Veterinarians often are involved in transplantation research projects. They are a fundamental social group who can influence public opinion about organ donation and transplantation (ODT).

OBJECTIVE

The objective was to determine the knowledge of Spanish veterinary students about the concept of brain death and the law of presumed consent.

METHODS

A sociologic, multicenter, and observational study was carried out in the veterinary students enrolled in Spain (n = 9000) in a complete academic year. A sample of 2815 students was stratified by geographic area and academic year. The students' attitudes on the psychosocial aspects of ODT were evaluated using a psychosocial validated questionnaire (PCID-DTO Rios). It was self-administered and completed anonymously. Veterinary schools were randomly selected. The questionnaire was applied to each academic year at compulsory sessions.

STATISTICAL ANALYSIS

Student t test, χ2 test, and logistic regression analysis were used.

RESULTS

The completion rate was 91% (n = 2558). Of students, 66% (n = 1664) understood the concept of brain death, 30% had doubts, whereas 5% believed that a person with brain death can recover and lead a normal life. Concerning legislation, 63% (n = 1615) were against the law of presumed consent, and 37% were in favor. An analysis of variables determining more favorable acceptance of the law showed that year of study (P = .000), knowing a donor (P = .020), and attitude toward ODT (P = .000) did have an effect on acceptance. Most students, 71% (n = 1875), were interested in attending a talk about ODT.

CONCLUSION

Only 37% of Spanish veterinary students would accept the law of presumed consent. Most students were interested in attending an informative talk about ODT.

Knowledge and attitude of ICU nurses, students and patients towards the Austrian organ donation law

Background

A survey on the knowledge and attitudes towards the Austrian organ donation legislation (an opt-out solution) of selected groups of the Austrian population taking into account factors such as age, gender, level of education, affiliation to healthcare professions and health related studies was conducted.

Methods

An online survey among 3 target groups (ICU nurses, health science students and non health science students) was performed and results were compared to the answers from transplantation patients to a paper questionnaire. A total of 8415 persons were asked to participate in the survey and 2025 (24%) persons correctly completed the questionnaire. 1945 online responses (ICU nurses n = 185; students of health sciences n = 1277; students of non-health science related courses n = 483) were analysed and data were compared to 80 manually filled-in responses from patients from a previous study.

Results

84% of participants state that they know the Austrian organ donation legislation; this percentage varies significantly (p < 0.05) within the target groups and is influenced by demographic variables of the participants. 74% think that the law is good and 79% do not favour a change. Opinions and attitudes towards the legal situation are positively influenced by the affiliation to healthcare professions and health-related fields of study. Interviewed persons who were aware of the legislation before the survey had a more positive attitude towards the existing legislation (77% versus 74%, p < 0.05).

Conclusions

The information level on Austrian organ donation legislation is high. ICU nurses and those who did not know the law before were most critical towards the existing legislation. Therefore education to increase knowledge in the general population and goal-oriented efforts to increase awareness in the target groups should be emphasized.