A First Nation-Wide Survey of Public Attitudes Towards Socio-Economic Incentives to Increase Willingness to Donate Organs in Japan

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Abstract

Introduction

Following the amendment of the Organ Transplant Act in 2009, 41.9% of the public were willingness to be brain dead donors according to the governmental poll in 2017 but there has been no significant increase of deceased organ donors in Japan. Moreover, the act allows only organ donors to be declared brain dead legally. Japan is a country with the lowest ppm number of deceased donors in the world.

Materials and Methods

We conducted the first nation-wide internet panel survey in Japan in August 2017. A questionnaire was developed from earlier surveys. We asked 750 males and 750 females between the age of 20-69 about their attitudes regarding organ donation and the acceptability of monetary or social incentive options. IBM SPSS Statistics 22 was used for analysis.

Results

35 % were positive or very positive towards organ donation after brain death, 24% were negative or very negative, respectively, and the rest 41% were undecided or don’t know. 33% were willing to receive organ transplant if needed to save their own lives. 69% believed that organ donation helps others, although 20% believed that organ donation contributed to the grieving process for donor families. The opt-out system was supported by 23%. There was limited support for monetary incentives for organ donation (12%) and mandatory postmortem donation (11%), while 40% were positive to receive assistance in paying funeral expenses, 42% medical costs and 38% reimbursement of cash to deceased donor family from the government, respectively. Residential tax reduction (22%), health insurance fee reduction (23%) and cash payment to a favorite charity after death (20%) were not supported much. 32% were supportive of granting priority on organ waiting lists to individuals who had previously registered as organ donors. 28% were in favor of prioritizing on waiting list for deceased donor family. Of each incentive options, nearly 40-50% chose undecided.

Discussion

In our survey, one-third of the respondents were reported to be in favour of being a brain dead donor or organ recipient. According to the polls, 85% of the public in Denmark, 69% in UK and 59% in the U.S said yes to become organ donors after death. To make up for such a large difference, the government should do much to promote organ donation. Indirect monetary incentives such as assistance in paying funeral expenses and medical costs are more supported by the Japanese public than direct ones.

Conclusion

In our findings, the Japanese public showed less willingness to be an organ donor than other developed countries. The preference this sample demonstrated for grants after death shows that one does not want to benefit directly from organ donation after death but rather wants indirect or incidental grants such as helping funeral or medical costs. More preferable incentive policies should be investigated to be found acceptable by Japanese citizens.

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