*2.1.1. The message to the public has been inadequate*

From the earliest times of the transplantation era, the philosophy used for educational purposes has relied on the concept that organ donation is an expression of altruism and solidarity, a "gift" that will save or improve someone's life. In fact, several surveys have shown that, in general, people are open to donate their organs (or those of a family member) after death. However, when facing the moment of grief, a high percentage of people fail to remember this commitment and consequently the "gift of life" is questioned and does not come to fruition.

The inadequate societal response to the persistent lack of donated organs encourages the following conceptual changes in the philosophy of the organ donation message:


Successful implementation of these ideas requires acknowledgment by state health and education institutions, scientific societies, organ sharing organizations and representatives of monotheistic religions.

**Proposed solutions**:

**1.** Legal measures

**4.** Education

**1. Legal measures**

tion is a donor).

Laws about organ transplantation have been passing attempts to provide a better system of organ donation and distribution and to encourage individuals to volunteer as organ donors. In USA, in 1968, The Uniform Anatomical Gift Act was the first effort at providing a national organ and tissue donation policy. The act created a uniform legal procedure for persons who wish to donate organs and for hospitals and medical institutions that want to accept them. A 1986 federal law requires all hospitals participating in Medicare or Medicaid to implement a "required request" policy. Hospitals are required to discuss with potential donors and their

The Society, the Barriers to Organ Donation and Alternatives for a Change

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Consent and altruism remain core values of organ donation. The term consent is typically

**1.** Informed consent or "opt in" (only those who have given explicit consent are donors or the

**2.** Presumed consent or "opt out" (who has not refused to express their consent to the dona-

Presumed consent is one of a number of different varieties of consent. The paradigm of consent in biomedical ethics is to express consent. It appears in the Uniform Anatomical Gift Act's framework for organ donation as well as in rules of voluntary, informed consent in both

On the other hand presumed consent has always been perceived as the "best" system for

However, in both systems, the family has something to say, especially for the deceased who

Proposals to introduce presumed consent should have full knowledge of their organization and results in the countries in which this legal instrument is in force. In practice, the citizen is informed that his non-registration as a non-donor means that he is a donor. The experience has shown that, in general, the presumed consent has not nullified the will of the families.

families "the option of organ and tissue donation and their option to decline" [30].

Two types of legislation concerning organ donations are at present valid worldwide:

defined as a subject adhering to an agreement of principals and regulations.

expressed voluntary of their families in case of death).

therapy and research involving human participants.

society in terms of organ donations.

did not sign anything while alive.

People have thus to register if they do not want to donate their body.

**2.** Financial incentives **3.** Expanding donors

#### *2.1.2. The message has not been effectively transmitted*

Undoubtedly, a scientifically programmed and continuously disseminated MEDIA campaign will have an important influence on the improvement of social behavior toward transplantation and donation.

Nevertheless, on the other hand, the MEDIA can transmit prejudicial and negative information and the myths most commonly perpetuated as:


A recent study has shown that mass media can generate a conflicting image of organ donation. The inadequate information is responsible for a negative attitude on the part of many potential donors. Investigations on the effects of MEDIA on donation have shown that when people are not in favor, they often mention the negative effect of television programs [28]. The myths transmitted were more believed by the viewers, than by those who did not see these programs. The same phenomenon occurred regarding the donation between spectators and non-spectators.

Although these are not the only myths that the general public believes to be true, the media is a powerful support for them. A well-programmed and persistently disseminated media campaign might have an important influence on improving society's knowledge of organ donation and transplantation.

It has been proposed that the ability of the press to correct negative misinformation might be fundamentally improved with the collaboration between specialists in transplants and journalists in the drafting of news or recommendations on donation and transplantation to society [29].

The decision of an organ donor is one of the most important and significant behavior of a current world citizen.

A public debate regarding organ donation can inform and stimulate many people to be donors.
