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Volume: 15 Issue: 1 February 2017 - Supplement - 1

FULL TEXT

Questionnaire on Brain Death and Organ Procurement

Objectives: The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution.

Materials and Methods: We administered 2682 ques­tionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old). We included people from universities, colleges, and the general public and asked questions on the circumstances of death, the conditions of conversations around organ donation, and reasons for acceptance or refusal of donation. The identical questionnaire, consisting of 8 questions, was administered twice: before and after a teaching ses­sion on brain death and organ procurement. The study was approved by our Ethical Review Committee and in accordance with the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from all participants.

Results: We found that 72.1% understood brain death in the prequestionnaire and 88% understood brain death in the postquestionnaire, with 63.8% versus 68% accepting the concept of brain death, 50.6% versus 58.3% thinking that their religion is against brain death, 11.3% versus 11.3% carrying a donor card, 50.7% versus 58.9% wanting to carry a donor card, 46.4% versus 56.4% agreeing to give consent for organ donation if a relative was diagnosed with brain death, 28.3% versus 50% aware of the laws and regulations concerning brain death and organ donation and transplant in Jordan, and 35.4% versus 40% in agree­ment with the Presumed Consent Law, respectively.

Conclusions: In Jordan, along with legal requirements concerning brain death and organ donation and transplant, there is a lack of acceptance of organ donation after brain death, necessitating further work and activities to achieve self-sufficiency from donated organs.


Introduction

The reasons behind the acceptance or refusal of organ donation are still unclear. The purpose of this prospective study was to analyze attitudes toward brain death and organ procurement in Jordan.

Jordan first issued a law for the use of corneas from cadavers in 1956, and a law regarding the use of organs and tissues of the human body was issued in 1977 and adjusted in 2000. Instructions for the trans­plant of human organs and tissues were issued in 1999 and adjusted in 2015, and the general procedure manual for donation, procurement, and transplant of human organs, tissues, and cells in the Hashemite Kingdom of Jordan was issued in 2015.1-9

Materials and Methods

We administered 2682 questionnaires to 628 men and 2054 women over 24 months. The participants ranged in age from 18 to 70 years. We included people from universities, colleges, and from the general public, and asked questions on the circumstances of death, the conditions of the conversations around organ donation, and the reasons for acceptance or refusal of donation. The identical questionnaire, consisting of 8 questions, was administered twice: before and after a teaching session on brain death and organ procurement. The study was approved by the Ethical Review Committee of the Institute. All of the protocols conformed to the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from all participants.

Results

The results of the questionnaires administered before and after the brain death and organ procurement teaching sessions are summarized in Tables 1 and 2.

Figure 1 shows that there was an increase in awareness regarding brain death from before to after the teaching session. There was also an increase in the percentage of people who would agree to give consent for organ donation if a relative was diagnosed with brain death (Figure 2). The most common reason for rejecting the idea of organ transplant after brain death was the fear that the organs are taken before death actually occurs (Figure 3).

Discussion

The following factors play an essential role in decision-making around organ transplant: the individual’s level of education, religion, and cultural norms (it is a criminal offense to donate body parts of relatives after brain death). The desire to donate organs after brain death in our society is lacking, which highlights the importance of further work to increase awareness and achieve a sufficient number of donated organs.


References:

  1. The General Procedures Manual for Donation, Procurement and Transplantation of Human Organs, Tissues and Cells in Hashemite Kingdom of Jordan, 2015. http://www.moh.gov.jo/AR/Pages/ServicesGuidlines.aspx.
  2. Purport of the Senior Ulama Commission Decision No 99 Dated (06/11/1402/H) - (1986 AD). http://www.moh.gov.jo/AR/Pages/ServicesGuidlines.aspx. Page 30
  3. Resolution of the Council of Islamic Jurisprudence on Resuscitation Apparatus Decision. http://www.moh.gov.jo/AR/Pages/ServicesGuidlines.aspx. No. (5) D 3/07/1986; page 30.
  4. Jordan Issued a Law for Use Cornea From Cadaver in 1956. http://site.eastlaws.com/GeneralSearch/Home/ArticlesTDetails?MasterID=74672.
  5. The Law of the Usage of Organs and Tissues of Human Body. http://www.moh.gov.jo/AR/Pages/HumanOrganDonationandUsageLaw.aspx. Issued in 1977 and adjusted in 2000.
  6. WHO Guiding Principles on Human Cell, Tissue and Organ Transplantation in 2010. http://www.declarationofistanbul.org.
  7. Instructions of Transplantation of Human Organs and Tissues. http://www.moh.gov.jo/AR/Pages/RulesandRegulations.aspx. Issued in 1999, adjusted in 2015.
  8. Arab Convention for the Project Regulating the Transfer and Transplantation of Human Organs and Prevent Trafficking 2014. www.cairo@fm.gov.jo.
  9. Ministry of Health of Spain Questionnaire. Global observatory on Donation and Transplantation. http://www.transplant-observatory.org.


Volume : 15
Issue : 1
Pages : 121 - 123
DOI : 10.6002/ect.mesot2016.O115


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From the Jordanian Center for Organ Transplantation Directorate (JCOTD) and the Ministry of Health, Amman, Jordan
Acknowledgements: The authors declare that they have no sources of funding for this study, and they have no conflicts of interest to declare.
Corresponding author: Saleh Hammad, Jordanian Center for Organ Transplantation Directorate (JCOTD) and the Ministry of Health, Amman, Jordan
Phone: +962 79 548 8803
E-mail: dr_salehhammad@yahoo.com