Cultural Impact On Organ Donation
This research paper discusses the impact of culture on organ donation around the world. The beliefs of various cultural groups are defined. It is concluded that culture and religion work together to influence people’s decisions about organ donation. In most cases it is difficult to tell the difference between the impacts of cultural versus religious beliefs. In some cases, however, the difference is clear. Culture, in the present discussion, includes the socioeconomic outlook of a particular group of people. As an example, the Asians in the United Kingdom shirk from organ donation because the Muslims among them are not sure whether their religion permits this form of charity. The author concludes that this is because most of South Asia is illiterate, and therefore, illiteracy is part of the cultural outlook of the society as a whole.
To people with organ failure anywhere in the world, organ transplants are known as gifts of life and gifts of love. It is a separate matter altogether that all patients will not receive organ donations in times of need. This could be due to cultural restraints, religious beliefs, or a shortage of donor organs While certain groups of people would not permit themselves to become the selfless donors of organs during their lifetimes or upon death, there are others that do not allow themselves to use donated organs because of individual beliefs, regardless of whether we consider these puritanical or not. Financial considerations also come into play. In poorer parts of the world where organs are sold much of the time, the majority may not be able to afford them.
In the United Kingdom, more than six thousand persons each year wait for a donor organ to arrive in time and save their lives. They go through severe illness and painful treatment during this indefinite waiting period. There are fewer than three thousand organ transplants carried out every year. And, at least four hundred people die while waiting (Macnair 2006).
Dr. Trisha Macnair of UK reports that the South Asian, African and African-Caribbean people are three to four times more likely to need an organ donation owing to special genetic factors. However, it is not easy to find organs for them because the Asians and the Black African folks do not readily agree to organ transplantation. Only 2.4 percent of the people registered for organ donation belong to ethnic minority groups.
Dr. Macnair writes: “The best match is likely to come from someone from the same ethnic group.” This is because certain genetic types are more likely to occur within particular populations and unusual blood groups often found among particular minority ethnic groups. Thence it is important for Asian and African blood and organs to be available at all times Truth is that although Asians make up only 2.7 percent of population in the United Kingdom, they account for 16 percent of those waiting for an organ transplant. In the same way, Africans make up only 2 percent of the UK population but 6 percent of the waiting list for kidney transplants.
Even though Britain’s main religions – Buddhism, Christianity, Hinduism, Islam, Judaism and Sikhism – do not forbid organ donation, at least seventeen percent of the people in Asian communities trust that their religions have said no to it, and thirty percent are uncertain. Similarly, the Black people are averse to organ transplants because of fears, such as the fear of being used for experimentation, or having an organ taken before one’s actual death (Macnair).
Clive O. Callender conducted research on the American Black community’s beliefs about organ transplantation in 1982. It was found that the principal reasons for the Black people disagreeing with the idea of organ donation were: (1) religious beliefs; (2) an unwillingness to reflect on death; and (3) the fear that a donor might be left without adequate medical care (Arnason 1991). Callender also reported, “There was considerable concern over the negative implications of cross-race transplants. A significant number of respondents preferred not to cross racial barriers because they felt the black kidney was superior” (Callender 1989). Jeffrey M. Prottas (1983), when writing on altruism with reference to racism in the United States, discussed that Black families often express the belief that organ donation mainly helps the whites, and therefore, the Black people will not cooperate to that end.
Nephrology Dialysis and Transplantation (1998) published an exploratory study examining the influence of religion on attitudes toward organ donation among Asian people in Luton, UK. According to the results, religion and culture play a less prohibitive role in determining whether an Asian person would donate his organs. The shortage of organ donors in the Asian community is rather due to a general lack of awareness when it comes to religious precepts on the issue. As an example, only two out of the thirty two Muslim subjects in the research reported that they had knowledge about their religion permitting organ transplants. It was concluded that there are clear misunderstandings about organ transplantation in general among the Asians of Great Britain.
In Canada, most organs for transplantation come from the dead instead of the living. Hence, the definition of brain death brings its own issues to the surface. Bowman and Richard (2004) write: “Although brain death is widely accepted by health-care workers as a legitimate definition of death, from a non-medical perspective, the moment of death is not always self-evident. That is, the space between life and death is socially, culturally and politically constructed, and is fluid and open to dispute.” Since Canada is a culturally diverse nation and respectful of diversity, health workers are urged to conform to the cultural standards of groups that donate organs. In other words, doctors cannot compel a family to donate the organs of a deceased loved one if he is only brain dead and the family refuses to accept the death at this point even if it was previously confirmed that the organs would be donated upon death.
Based on cultural beliefs that are often intertwined with religious traditions, people may conduct particular burial and funeral rites that do not allow for organ donation. The Japanese, for instance, traditionally believe that the dead body must remain whole because the soul would become unhappy in the next world if his organs are removed in this one given that there is a fragment of the deceased’s mind and spirit in every part of the dead body (Morioka 1995). Margaret Lock (2002), the author of Twice Dead: Organ Transplants and the Reinvention of Death, thinks that it is a mind-boggling tradition knowing that the Japanese are Number One in terms of gathering medical equipment and seem to have faith in rationality more than anything else. On the question of death, then, emotions may overpower reason.
The Chinese people view death as a social event rather than a scientific phenomenon (Ikels 1997). Uncomfortable with organ donation, they are not unlike many of the Canadian aboriginal folks (Emory 2001). Although the Gypsies or the Romas do not have an authoritative religion, they too are averse to organ transplantation because they have faith that the human being must be left intact upon death for a good afterlife (Florez 2004). On the other hand are a great number of Christians who treat organ transplantation as simply an act of love (Scorsone 1990).
According to Bowman and Richard, “Cultures are maps of meaning through which people understand the world and interpret things around them. Deeply ingrained in the roots of a society, culture often influences attitudes toward treatments such as organ donation.” From the information we have gathered about the Asians (Chinese, Japanese, and South Asian), the Blacks, and the Gypsies, it is evident that culture is indeed influencing people’s decisions about organ donation only if we include a society’s religious values in addition to its economic and general state of affairs in the definition of culture. Whereas the Japanese are basing their decisions about organ donation on religion alone, the South Asians in the UK seem to lack clear knowledge about the issue at hand, which could be due to the underdeveloped (and therefore, uneducated) state of most of South Asia. Culture includes the upbringing of a human society. Thus, the Blacks are utilizing the values they have learned in a culture that magnifies racism.
People almost always turn to religious answers on the question of death. Many religions give their adherents the freedom to choose whether to donate their organs and blood or not. Still, when it comes to racial discrimination in the matter of organ transplantation, one has to understand that it is not dictated by religion and only culture is making an impact on people’s decisions. Similarly, persons that are not guided by or learned in religion may make their choices entirely based on cultural factors. For instance, a Muslim who does not have knowledge that his faith permits organ donation may adopt the Christian values of unconditional love living in a society that is predominantly Christian in terms of its cultural values. The contingency theory is conclusive in this regard. “It depends!” – says the theory.
References
1. Arnason, Wayne B. 1991. “Directed Donation: The Relevance of Race.” The Hastings Center Report, Vol. 21.
2. Bowman, Kerry W., and Richard, Shawn A. 2004. “Cultural Considerations for Canadians in the Diagnosis of Brain Death.” Canadian Journal of Anesthesia 51:273-75.
3. Callender, Clive O. 1989. “Attitudes among Blacks towards Donating Kidneys for Transplantation: A Pilot Project.” JAMA 807: 74.
4. Emory, M. 2001. Native America Calling. Available online: http://www.nativeamericacalling.com/. [Accessed 18 October 2006].
5. Florez, Mandy. 2004. “Organ Donation: Moral Reasoning.” Available online: http://csmstu01.csm.edu/students/Spring2003/mflorez/. [Accessed 18 October 2006].
6. Ikels, C. 1997. “Kidney Failure and Transplantation in China.” Soc Sci Med 44: 1271-83.
7. Lock, Margaret. 2002. Twice Dead: Organ Transplants and the Reinvention of Death. University of California Press.
8. Macnair, Dr. Trisha. 2006. Donation – Interactive Journey Available online: http://www.bbc.co.uk/health/donation/. [Accessed 18 October 2006].
9. Morioka, M. 1995. “Bioethics and Japanese Culture: Brain Death, Patients’ Rights and Cultural Factors.”Eubios Journal of Asian and International Bioethics 5: 87-90.
10. Nephrology Dialysis and Transplantation. 1998. “An Exploratory Study Examining the Influence of Religion on Attitudes Towards Organ Donation Among the Asian Population in Luton, UK.” Volume 13: 1949-54.
11. Prottas, Jeffrey M. 1983. “Encouraging Altruism: Public Attitudes and the Marketing of Organ Donation.”Millbank Memorial Fund Quarterly 61: 293.
12. Scorsone, S. 1990. “Christianity and the Significance of the Human Body.” Transplant Proc 22: 943-4.
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