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Enforcement of presumed-consent policy and willingness to donate organs as identified in the European Union Survey: The role of legislation in reinforcing ideology in pluralistic societies

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  • Verheijde, Joseph L.
  • Rady, Mohamed Y.
  • McGregor, Joan L.
  • Friederich-Murray, Catherine

Abstract

To increase the supply of transplantable organs, some European Union (EU) countries have begun implementing and enforcing presumed consent policies for organ donation. Mossialos and colleagues performed an analysis of samples of citizens in 15 EU countries and found that legislation, enforcement, and awareness of presumed consent policies for organ donation increase people's willingness to donate their own organs and those of a deceased relative. The authors concluded that, in countries with enforced presumed consent, citizens are willing to donate because they accept organ donation as an ideology. This ideology originates in the thinking that organ donation is an implicit communal contract i.e., a mechanism by which individuals pay back society for the inclusion and social support that they have already experienced and hope to experience in the future. Acceptance of this ideology enhances people's willingness to donate organs and the efficiency in pursuing this collective action, thus, paving the way toward increased paternalism in society. We highlight some potential biases that may have been incorporated in the survey design and in Mossialos et al.'s conclusions, including (1) how the survey questions were constructed, (2) whether sufficient information was communicated about organ procurement practices in heart-beating and non-heart-beating donation before participants responded to the survey, and (3) whether respondents' knowledge about donation legislation can be equated with understanding of processes involved in organ donation. We address the consequences of using legislative authority to enforce the ideology of organ donation, thereby superseding the varying moral values, beliefs, and attitudes about human life and culture that are inherent in multicultural societies.

Suggested Citation

  • Verheijde, Joseph L. & Rady, Mohamed Y. & McGregor, Joan L. & Friederich-Murray, Catherine, 2009. "Enforcement of presumed-consent policy and willingness to donate organs as identified in the European Union Survey: The role of legislation in reinforcing ideology in pluralistic societies," Health Policy, Elsevier, vol. 90(1), pages 26-31, April.
    • Handle: RePEc:eee:hepoli:v:90:y:2009:i:1:p:26-31
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    References listed on IDEAS

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    1. Reubsaet, Astrid & van den Borne, Bart & Brug, Johannes & Pruyn, Jean & van Hooff, Hans, 2001. "Determinants of the intention of Dutch adolescents to register as organ donors," Social Science & Medicine, Elsevier, vol. 53(3), pages 383-392, August.
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    3. Long, Tracy & Sque, Magi & Addington-Hall, Julia, 2008. "Conflict rationalisation: How family members cope with a diagnosis of brain stem death," Social Science & Medicine, Elsevier, vol. 67(2), pages 253-261, July.
    4. Horton, Raymond L. & Horton, Patricia J., 1990. "Knowledge regarding organ donation: Identifying and overcoming barriers to organ donation," Social Science & Medicine, Elsevier, vol. 31(7), pages 791-800, January.
    5. Mocan, Naci & Tekin, Erdal, 2007. "The determinants of the willingness to donate an organ among young adults: Evidence from the United States and the European Union," Social Science & Medicine, Elsevier, vol. 65(12), pages 2527-2538, December.
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