⌚ Cultural Views On Organ Donation
However, Plutarchs Influence On Julius Caesar those Cultural Views On Organ Donation correctly to produce final answers as to who Cultural Views On Organ Donation organs does require medical knowledge and Cultural Views On Organ Donation other knowledge besides. Retrieved 31 August Finally, Native American, Cultural Views On Organ Donation, and Cultural Views On Organ Donation cultures emphasize that words should be carefully chosen because once spoken, they Disparities Among Ethnic Groups become a reality. As far as literacy levels are concerned, South Africa is ranked th out of countries. Department of Health and Human Services.
Giving the Gift of Life through Organ Donation: Chris Barry at TEDxFlourCity
About 20 patients die each day waiting for an organ on the transplant list. The UNOS computer matching system finds a match for the organ based on a number of factors including blood type and other immune factors, size of the organ, medical urgency of the recipient, distance between donor and recipient, and time the recipient has been waiting on the waitlist. Because of the significant need for organs for transplantation, there is ethical debate around where the organs can be obtained from and whether some organs are obtained illegally or through coercion.
In , the Swedish tabloid Aftonbladet triggered international controversy by claiming that Israeli troops killed Palestinians in order to harvest their organs — the Israeli government condemned the allegations as an antisemitic libel. In , China admitted to using the organs of executed prisoners for transplant. Almost all the organs transplanted from deceased donors came from executed prisoners. It is possible to schedule these surgeries in advance which is not possible in systems which rely on voluntary organ donation. Before , India had no legislation banning the sale of organs. Patients were often promised payments that were much higher than what they actually received.
In particular, the THOA bars strangers from donating to one another; a person can only donate to a relative, spouse, or someone bound by "affection. Often, claims of "affection" are unfounded and the organ donor has no connection to the recipient. The Aftonbladet—Israel controversy refers to the controversy that followed the publication of a 17 August article in the Swedish tabloid Aftonbladet , one of the largest daily newspapers in the Nordic countries.
The article alleged that Israeli troops harvested organs from Palestinians who had died in their custody. Sparking a fierce debate in Sweden and abroad, the article created a rift between the Swedish and the Israeli governments. It presented allegations that in the late s and the early s, many young men from the West Bank and Gaza Strip had been seized by Israeli forces and their bodies returned to their families with organs missing.
The Israeli government and several US representatives   condemned the article as baseless and incendiary, noted the history of antisemitism and blood libels against Jews and asked the Swedish government to denounce the article. The government refused, citing freedom of the press and the Swedish constitution. Swedish ambassador to Israel Elisabet Borsiin Bonnier condemned the article as "shocking and appalling" and stated that freedom of the press carries responsibility, but the Swedish government distanced itself from her remarks.
The former warned of venturing onto a slope with government officials damning occurrences in Swedish media, which may curb warranted debate and restrain freedom of expression by self-censorship. In December , a interview with the chief pathologist at the L. Greenberg National Institute of Forensic Medicine Yehuda Hiss was released in which he had admitted taking organs from the corpses of Israeli soldiers, Israeli citizens, Palestinians and foreign workers without their families' permission. Israeli health officials confirmed Hiss's confession but stated that such incidents had ended in the s and noted that Hiss had been removed from his post. The Palestinian press claimed the report "appeared to confirm Palestinians' allegations that Israel returned their relatives' bodies with their chests sewn up, having harvested their organs".
Several news agencies reported that the Aftonbladet article had claimed that Israel killed Palestinians to harvest their organs,  although the author, the culture editor for Aftonbladet , and Nancy Scheper-Hughes denied that it had made that claim. Although the sale of organs was not legal in the Philippines , prior to the practice was tolerated and even endorsed by the government. One high-ranking government official estimated that kidneys were sold annually in the country prior to ,  and the WHO listed it as one of the top 5 sites for transplant tourists in In March , the government passed new legislation enforcing the ban on organ sales banned the sale of organs. After the crackdown on the practice, the number of transplants has decreased from 1, in to in In the United States in , there were 19, kidney transplants, 7, liver transplants, 3, heart transplants, and 2, lung transplants performed.
In the United States, there are a total of 58 Organ Procurement Organizations OPOs that are responsible for evaluating the candidacy of deceased donors for organ donation as well as coordinating the procurement of the organs. This is of particular concern for liver transplant patients because transplantation is the only cure to end-stage liver disease and without a transplant, these patients will die.
In some regions, the wait time was as short as 4 months, while in others, it was more than 3 years. From Wikipedia, the free encyclopedia. Redirected from Organ harvesting. Surgical procedure that removes organs or tissues for reuse. The examples and perspective in this article deal primarily with the United States and do not represent a worldwide view of the subject. You may improve this article , discuss the issue on the talk page , or create a new article , as appropriate. February Learn how and when to remove this template message. Main article: Ethics of organ transplantation. Main article: Aftonbladet Israel controversy. Retrieved Hall, Jesse B. Fourth ed. New York. ISBN OCLC August Journal of the South Carolina Medical Association ISSN PMC PMID Schwartz, Seymour I.
Charles,, Andersen, Dana K. In the United States, this protection may include deliberately not translating diagnosis and treatment information to patients, 16 a situation that is less likely to arise with appropriate use of a translator Table 2. Physicians should orient the translator to the process of the medical encounter. Physicians should request the translator to ask the physician to restate or clarify unfamiliar terms. The physician should look directly at the patient, rather than at the translator, when either the physician or patient is speaking. The physician should speak in the second person. Information from references 17 and There are four primary reasons for non-disclosure: 1 certain cultures specifically view discussion of serious illness and death as disrespectful or impolite 5 , 19 , 20 ; 2 some cultures believe that open discussion of serious illness may provoke unnecessary depression or anxiety in the patient; 3 some cultures believe that direct disclosure may eliminate hope; and 4 some cultures believe that speaking aloud about a condition, even in a hypothetic sense, makes death or terminal illness real because of the power of the spoken word.
In many Asian cultures, it is perceived as unnecessarily cruel to directly inform a patient of a cancer diagnosis. Emotional reaction to news of serious illness is also considered directly harmful to health. It is thought that a patient who is already in pain should not have to grapple with feelings of depression as well. In addition, the special status of the elderly in Asian culture includes a value that they should not be burdened unnecessarily when they are ill.
Direct disclosure of bad health news may eliminate patient hope. Bosnian respondents indicated that they expected physicians to maintain patients' optimism by not revealing terminal diagnoses. Finally, Native American, Filipino, and Bosnian cultures emphasize that words should be carefully chosen because once spoken, they may become a reality. For example, a commonly held Navajo belief is that negative words and thoughts about health become self-fulfilling.
Similarly, the reluctance of Chinese patients and their families to discuss possible death is based on the belief that direct acknowledgement of mortality may be self-fulfilling. In the past 30 years, the U. A patient's capacity for making independent decisions is questioned only if cognitive function or patient judgment appears to be impaired by medical or psychiatric illness. In contrast, many ethnic communities view it as appropriate to withhold potentially distressing information from cognitively intact, competent patients. Therefore, the North American cultural norm of individual decision making about medical care may have to be altered when physicians care for ethnically diverse patients.
Alternate models of decision making include family-based, physician-based, and shared physician-family decision making Table 3. What is your preference? I will answer any questions you have. Could you explain to me what you understand about your mother's condition and the treatment that we are recommending? Are you comfortable with me treating you? Will you please let me know if there is anything about your background that would be helpful for me to know in working with you or your mother, father, sister, brother? Information from references 5 , 19 ,and Cultures that place a higher value on beneficence and nonmaleficence relative to autonomy have a long tradition of family-centered health care decisions.
In this collective decision process, relatives receive information about the patient's diagnosis and prognosis and make treatment choices, often without the patient's input. Compared with persons of black and European descent, Koreans and Mexican-Americans were more likely to consider family members, rather than the patient alone, as holding the decision-making power regarding life support. However, acculturated Mexican-Americans continued to view decision making as a family-centered process. Among Asian cultures, family-based medical decisions are a function of filial piety—an orientation toward the extended family as opposed to individual patient self-interest.
Many societies attribute a high degree of authority, respect, and deference to physicians. Eastern European medicine has had a long tradition of physician-centered, paternalistic decision making. In Russian medicine, the physician rather than the patient or patient's family often unilaterally determines a patient's level of life support. In Asian, Indian, and Pakistani cultures, family members and physicians may share decisional duties.
Family care of the terminally ill in Asian and Indian cultures is a shared responsibility for cognitively intact and incapacitated relatives. Physicians in Pakistan may be adopted into the family unit and addressed as parent, aunt, uncle, or sibling. Survey data suggest that about 20 percent of the U. The low rates of advance directive completion among non-whites may reflect distrust of the health care system, health care disparities, cultural perspectives on death and suffering, and family dynamics such as parent-child relationships Tables 3 5 , 19 , 25 and 4 34 , Ethnic minorities, which compose about one third of the U.
Physicians can become knowledgeable about cultural norms in patients they commonly treat. They can describe the dimensions as they apply to specific ethnic groups see Table 1. Physicians should ask patients directly about cultural issues that may affect communication patterns and treatment. Up to 17 percent of the U. Physicians must find accessible, trained translators. Untrained translators should be briefly oriented to their role see Table 2. Some cultures view directly informing patients of a serious diagnosis as harmful. Physicians can ask patients if they would like to be directly informed of the results of medical investigations.
Physicians can let patients know that they will discuss the patient's condition with the patient at any time. These exchanges should be documented in the medical record see Table 3. Patients may prefer that their family members be the recipients of diagnostic and treatment information. If a patient prefers that family members receive information, find out which family member s. Treatment decisions may be made by an informally appointed family member, family-wide consensus, or physician-family collaboration.
Physicians should ask patients how they would like treatment decisions to be made. When compared with whites of Northern European background, patients who belong to other ethnic groups are less likely to complete formal advance directives. They can ask the patient or family if there is a preferred approach for making decisions on the patient's behalf. Patients from some cultures, particularly those with histories of health care discrimination, may not trust physicians who are of a different ethnic background. In this situation, it is good to ask patients directly if they are comfortable working with a physician of a different ethnic background.
When appropriate, physicians can acknowledge that members of a particular ethnicity have had histories of less than optimal care. Patients and family members can be encouraged to inform the physician immediately if they have quality-of-care concerns. Information from references 34 and Among blacks, nonacceptance of advance directives appears to be part of a much broader pattern of values regarding quality of life, as well as a historical legacy of segregation. DNR orders may be viewed as a way of limiting expensive health care or as cutting costs by ceasing care prematurely.
The Tuskegee syphilis study, 36 in which infected black men were followed for 40 years but were not informed of the availability of penicillin treatment, is well known in the black community. The reluctance of blacks to formally address end-of-life care also may stem from a history of health care discrimination. Although individual studies vary, the preponderance of evidence indicates that nonwhites, even after controlling for income, insurance status, and age, are less likely to receive a range of common medical interventions such as cardiac catheterization, immunizations, and analgesics for acute pain.
In addition to a historical legacy of unequal care, black patients also appear to view suffering somewhat differently than whites of European background. While whites may be concerned about dying patients undergoing needless suffering, black physicians and patients are more likely to think of suffering as spiritually meaningful, and life as always having some value. Among Hispanics, the lack of acceptance of advance directives may stem from a view of collective family responsibility. Instead, a consensually oriented decision-making approach appears to be more acceptable in this population. Formalization of this process is seen as unnecessary and potentially harmful, because it may lead to increased and extended family conflict. Finally, among Asians, aggressive treatment for elderly family members is likely to be guided by filial piety.
Asian adults feel a responsibility to reverently care for aging parents. This sense of obligation makes it difficult for relatives to request other than extraordinary measures. Physicians can actively develop rapport with ethnically diverse patients simply by demonstrating an interest in their cultural heritage. Attention to dimensions such as those listed in Table 1 6 , 7 should help physicians develop a more detailed understanding of important cultural issues.
The power imbalance of physician-patient interaction may make it particularly difficult for ethnic minority patients to directly request culturally sensitive care. Through skillful use of patient-centered questions Table 3 5 , 19 , 25 and by including interpreters as necessary Table 2 , 17 , 18 physicians can develop a richer understanding of patients' health care preferences. Patient preferences for nondisclosure of medical information and family-centered decision making may be disorienting initially to American-trained physicians.
When treating patients from cultures with norms of nondisclosure, physicians might describe the dimensions of informed consent and offer to provide diagnostic and treatment information Table 4. Physicians should also appreciate that, in certain cultures, while communication about serious illness and death may not be overt, information may be conveyed with subtlety. Facial expressions, voice tone, and other nonverbal cues may convey the seriousness of a patient's status without the necessity for explicit statements.
The physician's partnership with his or her patients and their families provides unique insight into their values, spirituality, and relationship dynamics, and may be especially helpful at the end of life. By eliciting and following cultural preferences regarding disclosure, advance planning, and decisional processes that relate to seriously ill patients, family physicians can provide culturally sensitive end-of-life care. Already a member or subscriber? Log in. Interested in AAFP membership? A scandal that had international repercussions hit the headlines 20 years ago when a syndicate operating in South Africa was uncovered that had been involved in selling kidneys from hundreds of illegal kidney transplants at hospitals in Johannesburg, Cape Town and Durban.
Fourthly, a national policy on organ and tissue procurement is critically needed. Healthcare providers in state and private hospitals must follow a uniform approach to organ and tissue procurement. Fifth, South Africa also needs a national or central database and procurement agency. Lastly, The National Health Act must be revised to address legal shortcomings when it comes to organ donation and respect for the wishes of donors. And regulations must be streamlined. Read the original article. AllAfrica publishes around reports a day from more than news organizations and over other institutions and individuals , representing a diversity of positions on every topic. We publish news and views ranging from vigorous opponents of governments to government publications and spokespersons.
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