Legal and Religious Determinants of Organ Donation in the Unites States

Summary In the United States there are currently 114,810a people waiting for an organ transplant and 18 people die each day while waiting. Organ transplantation is a process of removing and transplanting a viable organ from one person, called a donor into another person in need of transplantation, called a recipient. The donor can be a friend, a family member or simply a stranger. This process is often the only treatment for end state organ treatment and is practiced worldwide. The donor however, needs to agree to the donation. Organs that can be donated include the heart, kidneys, bone, small intestine, skin, liver, pancreas, lungs, bone marrow and eyes. It is important to mention that one organ donor can save up to eight lives by donating several organs. The major problem worldwide is that the demand for organs exceeds the supply of organs. This “terrible and unnecessary tragedy” is the result of a high percentage of potential donors that are lost either through absence of consent or through medical failure.6 Around two million people die each year in the US and most are not suitable for donation because of age or a disease. It is believed that the number of people whose organs are suitable for donation at time of death is around three times the number of actual donors. Organs can only be collected from people that died in hospitals because their organs are kept alive and functional by mechanical ventilation until the transplantation can take place. Only about half of the people that die, die in hospitals.8 Despite all the medical advances in the last decades, the gap continues to widen. According to a study by Rumsey, Hurford and Cole, three main variables have an effect on people’s attitudes towards living as well as deceased donation. The first variable is education concerning organ donation. The second one are the religious beliefs towards donation and finally it appears that knowing someone who received or donated an organ can have an influence on people’s attitudes toward donation. Another variable that can have an effect on donation is the legislation that is used that deals with organ donation. In this paper, I will focus on organ donation rather than on organ transplantation because the supply side of organ donation is of main interest. Moreover, the concentration will be on deceased donors rather than on living donors. From 1988 until today, there are a total of 266 743 donors, from which 149 118 are deceased and 117 625 are living donors. In other words, 56% of donors are deceased donors. The focus will be on the United States. An important point is that deceased donors can donate more organs than living donors and as a result one person can save up to eight lives. By increasing the number of deceased donors, the number of available organs will increase much more than if the number of living donors increases. The thesis will try to answer the following questions: How is organ donation legally organized in the United States and what do the different religions say regarding donation? Moreover, what is the impact of those legal and religious aspects on organ donation? As can be read in the research question, the focus will be on the United States. The decision to analyze the United States is because the US is a melting point of a variety of religions and its legal framework regarding organ donation is very interesting. The two questions will be answered theoretically and empirically respectively. The former will include a general review of the literature regarding law and religion. Moreover, the literature review will also include the most important concepts when dealing with organ donation. The latter will be answered statistically and will be much more specific. In order to answer the question empirically, linear regressions of various variables will be done using SPSS. Section 2 of the thesis deals with general aspects of organ donation such as the difference between living and deceased donors and the different systems of organ donation that exist worldwide. Section 3 looks at the legal aspects of organ donation, which include the Organ Procurement and Transplantation Network (OPTN) and its consequences as well as the Uniform Anatomical Gift Act (UAGA) of 1968 and its revisions. Section 4 analyzes the attitudes of several religions towards organ donation. Sections 3 and 4 answer the first part of the research question: How is organ donation legally organized and what do the different religions say regarding donation? Sections 5 & 6 consist of an explanation of the variables used in the statistical analysis and its results. This is necessary in order to answer the second part of the research question: What is the impact of those legal and religious aspects on organ donation? Section 7 is a brief discussion of what the limitations of the research are as well as implications for the future. The 8th and final part is the conclusion.