A change in attitude among doctors, and information campaigns, are two main factors that influence people’s feelings towards organ donation, according to a recent study.

The study, carried out by psychologist Mary Anne Lauri, is called Attitudes towards organ donation in Malta in the last decade and it was published in the December issue of the Malta Medical Journal.

Mrs Lauri quoted foreign research that stated that potential organ donors are people who are urban dwellers, females who are practicing Catholics, and those who know the favourable opinion of their relatives regarding donation and transplantation.

Also included are people who do not agree totally with the notion that the body should remain intact after death, those who have a favourable attitude towards autopsy and those who are blood donors.

However, she pointed out that while most people say they are in favour of organ donation, “it is only a small percentage of these people that actually carries the donor card.”

Mrs Lauri said that often doctors do not know how to approach the family of the deceased about organ donation.

“When approached about organ donation, the family of the deceased are still in shock from the news of the death of their family member. It is for this reason that doctors very often find it difficult to approach the family and ask for permission to take organs.”

Furthermore, she said, the family feel that by “giving permission to doctors they might be showing disrespect to the dead person.”

This often happens when the family does not know the wishes of their relative regarding organ donation.

Ms Lauri also noted that even though most physicians are in favour of organ donation, some “are not convinced of the cost-effectiveness of organ donation and may argue that there are other interventions which are more worthy of support.”

Religious misconceptions also hinder organ donation. The study said that many people believe that a person should be buried intact.

“There is a reluctance associated with processes such as organ removal or post-mortems because it is believed that these medical procedures interfere with the afterlife.”

Furthermore, she pointed out, there was a time when various religions – including the Roman Catholic Church – were against organ donation.

However, even though the situation has now changed and many religions have revised their opinion, “this change in the position towards organ donation is not widely known. Many people still believe it is not allowed or encouraged.”

Awareness campaigns not only remind people to sign a donor card, but also inform them about the shortage of organs and “that, because of this shortage, people may die,” said Mrs Lauri.

A number of surveys were carried out in Malta following the first organ donation campaign, which took place in 1995, to establish its short and long-term effectiveness.

It was found that if relatives had known the wishes of the deceased, it would have greatly facilitated their decision, and that the campaign helped the respondents agree to donate a relative’s organs.

She also pointed out that the number of organ donations in 1996 – a year after the campaign – was substantially higher than in previous years.

In 1996, there were fewer than 15 organ transplants carried out, increasing to 33 in 1997.

Over the following years, the number of organ transplants remained the same, fluctuating only slightly.

However, said Mrs Lauri, there were other factors that contributed to the increase in organ transplants. Among these was an increase of beds in the Intensive Treatment Unit, the appointment of another transplant surgeon and better donor testing.

She also pointed out that Malta has an agreement with an Italian hospital and “when the organs procured from an already-dead donor are incompatible with any of the Maltese patients waiting for a transplant, these are sent to the Italian hospital.”