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Organ donation survey disputed

Eurobarometer findings don't match reality, officials say

By Kimberly Ashton
Staff Writer, The Prague Post
June 13th, 2007 issue

In Western Europe, it’s not uncommon for a person in need of a kidney to wait half a decade for a transplant. But, in the Czech Republic, the waiting list is much shorter. On average, patients wait less than 12 months.
The reason the list is substantially shorter here than in much of Europe is that there is a different donor system, known as a “presumed consent opt-out” system. What this means is that everyone is automatically considered a donor unless he or she has signed a national registry to opt out.
But none of this is reflected in a recent Eurobarometer survey that portrays a poor attitude among Czechs regarding organ donation.
“The most reluctant citizens are almost all from the Eastern European countries: especially in the Czech Republic, where public opinion is particularly divided (44 percent are in favor of donating one of their organs while 39 percent are against the idea),” the survey states.
The survey also found that only 19 percent of the national population — the lowest number in the European Union — have discussed organ donation or transplantation with family members.
But some question the survey’s methods, since it makes no distinction between the different laws that govern organ donation across Europe.
“I’m not happy with Eurobarometer because there is a discordance between real organ donation and this survey,” said Dr. Štefan Vítko, head of the transplant center at the Institute of Clinical and Experimental Medicine (IKEM) in Prague. “The survey doesn’t reflect the different situations in Europe.”
It’s also inaccurate. For example, it states that just 1 percent of Czechs have organ donor cards. In fact, since all citizens who haven’t opted out are considered donors, no one has this card, according to Vítko.
Also, the survey puts Spanish attitudes about organ donation as consistently more negative than those held by Scandinavians although Spain has the highest donor rate in Europe, Vítko said.
Furthermore, two IKEM studies within the past decade have found that most Czechs — 89 percent, according to one study — have a positive attitude about donating their organs. Because of the Eurobarometer results, IKEM will repeat its study, Vítko said.
Eurobarometer is the public opinion analysis arm of the European Commission, charged with surveying attitudes about social and economic issues. Representatives of the organization were unavailable to discuss its organ donor findings by press time.
According to Vítko, about one-third of Europe has the opt-out system, which maintains a negative registry of those who do not wish to donate. Doctors “always, in every case, check the registry” before harvesting organs, he said, adding that there has never been a case here in which organs were taken from an unwilling donor. The IKEM survey found that most of the public is aware of this system, Vítko said.
The number of transplants is also rising, according to the Czech Transplantation Society. In 1990, 122 kidneys were transplanted from dead donors and five from living donors. In 2006, those numbers were 395 and 33, respectively. Heart, lung and especially liver and pancreas transplants have also multiplied, according to the society’s statistics.
Even though most people are potential organ donors, very few will ever have the opportunity to donate. According to John Evans, chairman of the British Organ Donor Society, a nongovernmental group, only 1 of every 800 donors actually dies in a situation that makes donation possible. Organs are often damaged by disease or violence, and, even under ideal conditions, such as a hospital death, doctors have to diagnose brain-stem death before organs can be harvested.
The United Kingdom has a much longer waiting list for kidneys than the Czech Republic’s, but Evans said that he would not change his country’s informed consent law, which weighs family wishes heavily. Ultimately, the decision of whether to harvest a patient’s organs in the United Kingdom depends on the doctor, who takes both the patient’s expressed wishes and the families’ desires into account.
An opt-out law such as the Czech Republic’s could make sick people afraid to go to the hospital, Evans said, because of commonly held misperceptions of organ donation. One is the fear that organs will be taken while there is still a chance to save the donor’s life.
A major reason the list is so much longer in the United Kingdom, Evans says, is that more people are aware of organ donation and can afford it. “It’s a victim of its own success,” he said. Evans predicts the list in the Czech Republic will grow over time, too.

Kimberly Ashton can be reached at kashton@praguepost.com


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