The impact of knowledge and religion on organ donation as seen by immigrants in Sweden

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Transplantation of organs is one of the most successful medical advances of the past 60 years and transplantation is the treatment of choice for severe organ failure worldwide. Despite this, and involving many technical and organisational factors during the transplantations process, the final result depends on the final decision of people who are directly linked to the healthcare system 1. Current Swedish legislation states that when all brain functions are totally and irrevocably lost a person can be declared dead 2.This means that essential organs and tissues can be utilised for transplantation surgery because breathing and circulation can be maintained artificially. In Sweden, every year 250‐300 people die in a way that makes them potential organ donors. Of these, 100‐150 are medically suitable and of an age appropriate to become donors 3. Healthcare professionals have a very important role in providing support in the form of information to transplant patients and to those who choose to donate organs. Healthcare professionals should also ensure that ill individuals and their families have understood the information given in order to make an informed decision if they want to donate or not 4. Despite well‐functioning laws and competent healthcare professionals throughout the world, the demand for organs is greater than supply 1.
Previous studies 6 have shown a number of different factors associated with attitudes towards organ donation. Altruism and ability to save lives, body wholeness and dignity, family attitudes, grief and fear from the donor family were some of the indicated factors. It has also been shown that people are more willing to make a live donation to a family member than a donation after death 10. Furthermore, both a high and low degree of religious, cultural or socio‐economic level beliefs have been cited as barriers 13. In a study regarding patients declared brain dead, relatives talked about their experiences in an extremely difficult situation, characterised by anger, emotional pain, disbelief, guilt and suffering 15. The relatives described the difficulty of distinguishing the concept of brain death from coma 15. It was difficult to understand when their relatives died, if it was an acute event or when the life support machine was turned off. They lacked clear information and some found it difficult to grasp that the relative was dead when the body was warm and the chest moved 16. In another study, a group of relatives also felt that they had not received information clearly stating that their relative was brain dead before they were asked to make a decision and they felt pressurised and needed to decide quickly. Families who had denied the donation wanted information about the procedure transmitted in a better way. They wanted to hear the truth, but said that there are different ways to deliver it 19.
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