The case against more public education to promote organ donation (original) (raw)

1996, Journal of Transplant Coordination

Public Education and Changes in Behavior We argue that the transplant community needs more donors, not more donor awareness. Donor awareness is a necessary, but not sufficient, condition for actual donation. Public education that produces actual changes in behavior takes place only under certain conditions, and these conditions do not exist at the time of the decision to donate. Public education that leads to changes in behavior seems most successful when (1) the audience is large and can be easily targeted, (2) members of the audience see the message as directly pertinent to their own needs, (3) the behavior can be practiced repeatedly to achieve a level of competence, and (4) the behavior is public and can either be supported or discouraged by peer pressure. 3-5 None of these conditions pertain to the decision to donate. Determining a large target audience for educating potential organ donors is not possible. We do not know in advance, nor will we ever know, who will be making a decision about organ donation. For example, Howard Nathan 6 estimates that the size of the potential donor pool is approximately 47 donors per million. If we assume that for every potential donation there are two actual decision makers in a family, and if we were able to talk to all those decision makers, we would still have a real target audience of only 94 persons per million per year. (This estimate may be high 7 ; in 1993, only one OPO had more than 47 donors per million.) This number, 94 persons per million, is about the same as the number who die annually of anemia. 8 If we substitute for public education about organ donation the notion that we should educate the entire public about The case against more public education to promote organ donation The organ procurement community has always considered public education a primary challenge. According to conventional wisdom, greater awareness generated by public education will lead to more donated organs. This notion may be based on faulty assumptions about public education and about the relationship between awareness and behavior. Public education, as the primary focus for the organ procurement community, should be abandoned. Increased efforts in professional education and basic research are more appropriate endeavors for organ procurement organizations.