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Title: A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study
Authors: Muthiah, Mark D.
Chua, Melissa Sin Hui
Griva, Konstadina
Low, Ivan
Lim, Wen Hui
Ng, Cheng Han
Hwang, Jeff Y. F.
Yap, Jason C. H.
Iyer, Shridhar G.
Bonney, Glenn K.
Anantharaman, Vathsala
Huang, Daniel Q.
Tan, Eunice Xiang-Xuan
Lee, Guan-Huei
Kow, Alfred W. C.
Tai, Bee Choo
Keywords: Science::Medicine
Issue Date: 2021
Source: Muthiah, M. D., Chua, M. S. H., Griva, K., Low, I., Lim, W. H., Ng, C. H., Hwang, J. Y. F., Yap, J. C. H., Iyer, S. G., Bonney, G. K., Anantharaman, V., Huang, D. Q., Tan, E. X., Lee, G., Kow, A. W. C. & Tai, B. C. (2021). A multiethnic Asian perspective of presumed consent for organ donation: a population-based perception study. Frontiers in Public Health, 9, 712584-.
Project: MOH-000193 
Journal: Frontiers in Public Health 
Abstract: Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remains a paucity of literature on public attitude and barriers regarding the opt-out system, with existing studies limited to Western nations. Therefore, this study aimed to understand public sentiment and different barriers toward organ donation from the perspective of Singapore, a highly diverse and multiethnic Asian society. Methods: A cross-sectional community semi-structured interview was conducted in a public housing estate in Singapore. Pilot test was undertaken before participants were interviewed face-to-face by trained personnel. All statistical evaluations were conducted using Stata. The χ2-test compared subgroups based on patient characteristics while multivariable logistic regression identified predictors of willingness to donate/ assent. Effect estimates were quantified using odds ratio (OR). Findings: Out of 799 individuals, 85% were agreeable to organ donation after death and 81% were willing to assent to donations of family members' organs, which declined by 16% (p < 0.001) after a clinical scenario was presented. Demographic factors including ethnicity, education, marital, and employment status affected willingness to donate and assent. Knowledge correlated significantly with willingness to donate and assent. In particular, knowledge regarding brain death irreversibility had the strongest correlation (AOR 2.15; 95% CI 1.60-2.89). Conclusions: Organ donation rates remain low albeit presumed consent legislation, due to patient-level barriers, including but not limited to knowledge gaps, cultural values, religious backgrounds, and emotional impact at relatives' death. To effectively boost donor rates, it is crucial for policy makers to invest in public education and improve transplant provisions and family protocols.
ISSN: 2296-2565
DOI: 10.3389/fpubh.2021.712584
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Rights: © 2021 Muthiah, Chua, Griva, Low, Lim, Ng, Hwang, Yap, Iyer, Bonney, Anantharaman, Huang, Tan, Lee, Kow and Tai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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