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Health Psychology Group Project

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Shujuan Goh

on 5 February 2013

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Transcript of Health Psychology Group Project

TRANSPLANT An Act of Charity or Trade? Health Psychology Group Project
Afiq, Dylan, Joey, Ryan, Shujuan USA Statistics USA Statistics Forbids the buying and selling of human body parts
Only permits living-related and cadaveric organ transplants (Lim, 2008)
Health Minister stated some views…
Did not reject to the legalization of organ trade
Human Organ Transplant Act (Tan, 2008) Singapore India Kidney transplants are conducted in private “back-street” clinics (Chug & Jha, 1996)
Exploitation by rich foreigners is still acute throughout Asia India Exploited by middlemen and have their kidneys sold to wealthy patients.
(video) CONTENT 1. Organ Trade
Why is it allowed in some countries and not others?
Reasons for organ trade
Biopsychosocial impacts of organ trade

2. Organ Donation
Differing Attitudes
Raising AWareness India Legislation against organ trading in 1994
Led to a sharp increase in the prices of illegally transplanted kidneys (Sells, 2003)
Used to be one of the largest kidney transplant centers China Illegal organ trading continues to boom, particularly in kidneys (Phillips, 2012)
Kidneys are still sold openly on the Internet

Chinese Government then established an organ donation program but failed to attract sufficient donors
China is rated as having the lowest number of organ donation around the world Rising demand for organ transplantation but lowest rate of organ donation around the worldBlack market being the only alternative for patients who suffer from serious medical conditions
Organ trade is still the easiest and most profitable way despite being banned in China (Ritter, 2008) China Iran Only country that allows the sale of one’s kidneys for profit or compensation (Schall, 2008)No shortage of available organs or waiting lists for kidney transplantation (Ghods & Savaj, 2006; Organ Transplants, 2006)
Average amount for kidney transplant is $1,200 (Griffin, 2007) Iran Advertisements on sales of kidneys
Writing blood type and phone numbers on posters or walls near major hospitals A lot of competition for those selling kidneys (Dehghan, 2012)
Some advertisements are torn down by others
Some donors included their contact details to advertisements posted by other donors Iran Shortage of Organs Lack of Awareness Money-Making Model Poverty People in need of organs often turn to organ trade due to massive shortage of organs
17 people die each day while waiting for organs (Kishore, 2007)
Because of lack of options, they resort to organ trade Normal to feel that they are free to do as they please with their own organs
Act of organ trade is seen as a good deed People see the selling of their organs as a ticket out of poverty
Willing to do anything to help their financial situation Perceive the organ trade as lucrative
Often exploit the poor and desperate Organ Trade Why is it allowed in some and not others? Reasons for
Organ Trade Biopsychosocial Impacts
of Organ Trade Pain, weakness, weight loss and frequent illness were experienced (Moniruzzaman, 2012)
Lingering pain at the nephrectomy site and persistent back pain (Goyal et al., 2002)
Tiredness, dizziness and shortness of breath, heightened blood pressure or had blood or protein in their urine (Moazam et al., 2009)
Fatigue, fever, urinary tract symptoms, dyspepsia and the loss of appetite (Naqvi et al., 2008) Biological Impacts Impacts on Organ Sellers Medical studies claimed that:
Donors’ death risk owing to surgery is one in 3,000
Donors have an increased risk of developing chronic diseases Psychological Impacts Disembodiment and ontological suffering (Moniruzzaman, 2012)
Experience as having turned into a “half human” (Moazam et al., 2009)
Live in nothingness after the operation (Moniruzzaman, 2012)
Distressed due to the integrated selfhood they imagined with their recipients
Suicidal thoughts and drug addiction problems (Moniruzzaman, 2012) Social Impacts Extreme social suffering
Social isolation
Feelings of profound shame and experiences of mocking and teasing by others (Moazam et al., 2009)
Being labeled as “weak” and “disabled” (Scheper-Hughes, 2003)
Marital conflicts and divorces (Zargooshi 2001) Harsh economic conditions
Unemployment/fewer hours of work due to health problems
Decreased average family income
Increased number of sellers living below the poverty line Social Impacts Impact on Organ Sellers However, existing studies show that:
Kidney sellers' health deteriorated
Economic conditions worsened
Social standing declined
Profound psychological & psychosocial impacts Exploitation of the Vulnerable Sellers are poor and do not have many other ways to earn money
Pressured into selling their organs against their freewill
Not given a fair compensation for their contribution Organ Donation
Differing Attitudes Differing Attitudes Countries such as Australia and Iran, and cultures such as the Malay community in Malaysia and the Muslim Arab community in USA have the lowest organ donation rates
Studies conducted in this regions have found reasons why the community would participate in organ donation Differing Attitudes Australia (Hyde & White, 2010)
Most commons reason why they decline:
Do not feel their body will be whole after they die
Inability to have an open casket funeral
Quality and length of life has been reduces
Most common reasons why they donate:
If it saves and improve another’s life
If the person who needs the organ is a relative
If donor knows something about the recipient Differing Attitudes In a study conducted in Iran on whether families would donate their dead relative’s organs, they found, (Manzari et al., 2012).
Most commons reason why families decline:
They would humiliate their relative’s body
The fear of receiving negative responses from others, such as “being accused of selling one’s child for money”
Most common reasons why the families allow:
Helped them cope with the loss as it allowed them to feel that both the deceased relative and them have “become closer to God”
Positive impact of the act of donating has allowed them to feel better that they had made a contribution to humanity Differing Attitudes African American population (as cited in Padela, Rasheed, Warren, Choi, Mathur, 2011)
Religious beliefs
Mistrust of health care providers
Hispanic and Asian populations (as cited in Padela, Rasheed, Warren, Choi, Mathur, 2011)
Lack of public awareness of transplantation Differing Attitudes Arab Americans (Padela, Rasheed, Warren, Choi, Mathur, 2011)
Arab Americans who lived in USA for more than 10 years and are proficient in English seem to feel organ donation is more justifiable
Christian Arab Americans were more likely to see organ donation as justifiable as compared to Muslim Arab Americans
Even when Islamic scholars deny, most followers of the faith believe that Islam disallows them to donate their organs Differing Attitudes Malaysia (Noordin et al., 2012)
3 main races:
Malays were found to be the least likely of the three races in the country to donate organs Differing Attitudes Deterring factors (Noordin et al., 2012)
Majority of the Malay community is Muslim
Similar mind set to those in Iran
Confusion due to lack of discussion in the religion
Determined by one’s experiences
E.g: if an individual was influenced to perceive organ donation as immoral and degrading, the chances of the individual volunteering for organ donation is greatly lowered. Organ Donation
Raising Awareness The Problem The demand for organs is simply growing at an exponential rate, far too fast for the supply to keep up
Australia: 9.4 donors for every 1,000,000 people (Excell, Hee, & Russ, 2008).
Only 15% of the world’s possible organ supply is available (DeChesser, 1986) The Consequences Lack of available organs pushes people on the waiting list to go out and get it themselves, be it legal or not
Novelli et al. (2007): Urgent patient requests, Subpar National Health Service quality, Inadequate laws, Social conditions, and Indigent poverty
Black market increase = an increase in many other problems The Consequences 1. Compromises Recipients’ Health (Noel, 2007)
2. Make fools out of people (Shimazono, 2007)
3. Creates an unethical society (Novelli et al., 2007) Possible Solutions Don’t prevent the trade, instead regulate it
Regulated Prices + High Quality Allocation (Matas, 2004)
Educate masses about donation
Lack of knowledge is one of the main reasons why people don’t donate (Landolt et al., 2003)
Fear or premature death/post-procedure problems
False: Mortality rate only 0.03% and long-term risk is no different than population (Erin & Harris, 2003) Possible Solutions Cultural/social acceptance
People are afraid to tell their family that they wish to be a donor.
Research show that Social Domain is actually one of the main influences (Hyde & White, 2010)
Religious clarification can also aid people in deciding to be a donor Case Study: Iran National rates of transplant slowly decreasing over the years, possibly due to:
Physicians/Religious leaders consensus and clarification
Increasing the donor pool
High priority and quality/care
Further awards and sanctions given to donors
Led to elimination of organ waiting list in 1999 (Larijani, Taheri & Zahedi, 2004) THANK YOU
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