A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study
Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remain...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
2022
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| Online Access: | https://hdl.handle.net/10356/153941 |
| _version_ | 1826113950790451200 |
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| author | Muthiah, Mark D. Chua, Melissa Sin Hui Griva, Konstadina Low, Ivan Lim, Wen Hui Ng, Cheng Han Hwang, Jeff Y. F. Yap, Jason C. H. Iyer, Shridhar G. Bonney, Glenn K. Anantharaman, Vathsala Huang, Daniel Q. Tan, Eunice Xiang-Xuan Lee, Guan-Huei Kow, Alfred W. C. Tai, Bee Choo |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Muthiah, Mark D. Chua, Melissa Sin Hui Griva, Konstadina Low, Ivan Lim, Wen Hui Ng, Cheng Han Hwang, Jeff Y. F. Yap, Jason C. H. Iyer, Shridhar G. Bonney, Glenn K. Anantharaman, Vathsala Huang, Daniel Q. Tan, Eunice Xiang-Xuan Lee, Guan-Huei Kow, Alfred W. C. Tai, Bee Choo |
| author_sort | Muthiah, Mark D. |
| collection | NTU |
| description | Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remains a paucity of literature on public attitude and barriers regarding the opt-out system, with existing studies limited to Western nations. Therefore, this study aimed to understand public sentiment and different barriers toward organ donation from the perspective of Singapore, a highly diverse and multiethnic Asian society. Methods: A cross-sectional community semi-structured interview was conducted in a public housing estate in Singapore. Pilot test was undertaken before participants were interviewed face-to-face by trained personnel. All statistical evaluations were conducted using Stata. The χ2-test compared subgroups based on patient characteristics while multivariable logistic regression identified predictors of willingness to donate/ assent. Effect estimates were quantified using odds ratio (OR). Findings: Out of 799 individuals, 85% were agreeable to organ donation after death and 81% were willing to assent to donations of family members' organs, which declined by 16% (p < 0.001) after a clinical scenario was presented. Demographic factors including ethnicity, education, marital, and employment status affected willingness to donate and assent. Knowledge correlated significantly with willingness to donate and assent. In particular, knowledge regarding brain death irreversibility had the strongest correlation (AOR 2.15; 95% CI 1.60-2.89). Conclusions: Organ donation rates remain low albeit presumed consent legislation, due to patient-level barriers, including but not limited to knowledge gaps, cultural values, religious backgrounds, and emotional impact at relatives' death. To effectively boost donor rates, it is crucial for policy makers to invest in public education and improve transplant provisions and family protocols. |
| first_indexed | 2024-10-01T03:31:15Z |
| format | Journal Article |
| id | ntu-10356/153941 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T03:31:15Z |
| publishDate | 2022 |
| record_format | dspace |
| spelling | ntu-10356/1539412023-03-05T16:51:28Z A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study Muthiah, Mark D. Chua, Melissa Sin Hui Griva, Konstadina Low, Ivan Lim, Wen Hui Ng, Cheng Han Hwang, Jeff Y. F. Yap, Jason C. H. Iyer, Shridhar G. Bonney, Glenn K. Anantharaman, Vathsala Huang, Daniel Q. Tan, Eunice Xiang-Xuan Lee, Guan-Huei Kow, Alfred W. C. Tai, Bee Choo Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Presumed Consent Organ Transplantation Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remains a paucity of literature on public attitude and barriers regarding the opt-out system, with existing studies limited to Western nations. Therefore, this study aimed to understand public sentiment and different barriers toward organ donation from the perspective of Singapore, a highly diverse and multiethnic Asian society. Methods: A cross-sectional community semi-structured interview was conducted in a public housing estate in Singapore. Pilot test was undertaken before participants were interviewed face-to-face by trained personnel. All statistical evaluations were conducted using Stata. The χ2-test compared subgroups based on patient characteristics while multivariable logistic regression identified predictors of willingness to donate/ assent. Effect estimates were quantified using odds ratio (OR). Findings: Out of 799 individuals, 85% were agreeable to organ donation after death and 81% were willing to assent to donations of family members' organs, which declined by 16% (p < 0.001) after a clinical scenario was presented. Demographic factors including ethnicity, education, marital, and employment status affected willingness to donate and assent. Knowledge correlated significantly with willingness to donate and assent. In particular, knowledge regarding brain death irreversibility had the strongest correlation (AOR 2.15; 95% CI 1.60-2.89). Conclusions: Organ donation rates remain low albeit presumed consent legislation, due to patient-level barriers, including but not limited to knowledge gaps, cultural values, religious backgrounds, and emotional impact at relatives' death. To effectively boost donor rates, it is crucial for policy makers to invest in public education and improve transplant provisions and family protocols. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version MM acknowledges support by Singapore Ministry of Health’s National Medical Research Council, under its NRMC Research Training Fellowship MOH-000193. 2022-05-24T04:38:01Z 2022-05-24T04:38:01Z 2021 Journal Article Muthiah, M. D., Chua, M. S. H., Griva, K., Low, I., Lim, W. H., Ng, C. H., Hwang, J. Y. F., Yap, J. C. H., Iyer, S. G., Bonney, G. K., Anantharaman, V., Huang, D. Q., Tan, E. X., Lee, G., Kow, A. W. C. & Tai, B. C. (2021). A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study. Frontiers in Public Health, 9, 712584-. https://dx.doi.org/10.3389/fpubh.2021.712584 2296-2565 https://hdl.handle.net/10356/153941 10.3389/fpubh.2021.712584 34676192 2-s2.0-85117264487 9 712584 en MOH-000193 Frontiers in Public Health © 2021 Muthiah, Chua, Griva, Low, Lim, Ng, Hwang, Yap, Iyer, Bonney, Anantharaman, Huang, Tan, Lee, Kow and Tai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. application/pdf |
| spellingShingle | Science::Medicine Presumed Consent Organ Transplantation Muthiah, Mark D. Chua, Melissa Sin Hui Griva, Konstadina Low, Ivan Lim, Wen Hui Ng, Cheng Han Hwang, Jeff Y. F. Yap, Jason C. H. Iyer, Shridhar G. Bonney, Glenn K. Anantharaman, Vathsala Huang, Daniel Q. Tan, Eunice Xiang-Xuan Lee, Guan-Huei Kow, Alfred W. C. Tai, Bee Choo A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study |
| title | A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study |
| title_full | A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study |
| title_fullStr | A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study |
| title_full_unstemmed | A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study |
| title_short | A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study |
| title_sort | multiethnic asian perspective of presumed consent for organ donation a population based perception study |
| topic | Science::Medicine Presumed Consent Organ Transplantation |
| url | https://hdl.handle.net/10356/153941 |
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