Jordan Miller, PhD Candidate, University of Stirling
There are over 6,000 people waiting for a life-enhancing organ transplant in the UK, but there is a serious shortage of organ donors. Every day three people die waiting for a lifesaving transplant, so finding ways to increase the number of donors is crucial.
Under the current system, to be a donor you have to sign up and join the donor register. The opt-out system removes this condition and, instead, follows presumed consent. This means that if you take no action, you will become an organ donor by default. If you don’t want to be a donor, you must remove yourself from the donor register.
We know very little about what the public think of the opt-out system, what the public plan to do if the law changes and any factors that might deter potential donors. Our new research, found that public health campaigns that focus on facts may not be the best approach to overcoming barriers to organ donation.
Emotions play the greatest role
Research has now found specific emotional barriers to deter potential organ donors. These include medical mistrust, feelings of disgust about organ donation, concerns that joining the donor register may be “tempting fate”, and that organ donation violates the physical state of the body after death.
These factors can be intensified by harmful organ donation myths. A common example being that a doctor won’t try as hard to save your life if they know you are a potential organ donor.
These myths are difficult to dispel and are heightened by harmful depictions of organ donation in the media, such as in the TV drama, Grey’s Anatomy. Some episodes of the popular American TV series portrayed doctors as being impatient and careless when declaring a patient to be brain dead and, at times, manipulating the donor system to guarantee organs were donated to friends. To reduce these kinds of myths, healthcare organisations around the world use myth-busting campaigns to promote organ donation.
Putting myth busting to the test
In our study, we asked 1,202 members of the UK public what their donor choice would be if the laws changed to an opt-out system. We then measured if emotional barriers, such as medical mistrust, were amplified among this group of people.
To test if an NHS myth-busting campaign would increase intentions to be an organ donor, participants were presented with nine organ donation myths and asked if they believed them to be true or false. We then gave all participants accurate information to dispel the myth. Donor intentions were measured immediately before and after the myth-busting intervention.
The results suggest that if donor laws change in Scotland, England and Northern Ireland, around one in ten people plan to opt-out of the donor register. People who plan to opt-out of the donor register were also found to have higher negative emotional barriers towards organ donation, in particular, worries about their body being violated as a result of organ donation.
We also found that dispelling harmful myths with facts had no effect on donor intentions for the people who plan to opt-out
Facts versus feelings
Strategies designed to dispel harmful organ donation myths are often used on organ donation websites. But dispelling myths about organ donation did not have a positive impact on donor intentions for people who plan to opt-out. That’s not to say dispelling myths isn’t important, but for our target group, the people who plan to opt-out, it had no effect.
This is important, as a related study on promoting flu vaccinations found that myth-busting had a negative impact on intentions to vaccinate among people with negative attitudes. Instead, evidence has shown that feelings play a vital role in influencing donor behaviour. Yet the myth-busting campaign used by the NHS targets facts rather than feelings. This may explain why dispelling myths with evidence was not enough to influence donor intentions.
Some recent research has found campaigns that use organ donation testimonies to dispel harmful myths to be more effective at increasing donor consent in comparison to accurate information. Instead of a facts-versus-fiction approach, perhaps public health campaigns that target these visceral emotional beliefs may be more effective at breaking down emotional barriers.
This blog post originally appeared as an article on The Conversation.