Members of non-western cultures hold different attitudes towards organ donation, says a U of T researcher, and he says that our healthcare system needs to be more sensitive to these differences.
Kerry Bowman, a U of T professor with the Joint Centre for Bioethics and the clinical ethicist at Mount Sinai Hospital, points out that decisions regarding organ donation can only be made once a person is considered brain dead. Non-western cultures view the end of life in different ways, and this affects their perspective on organ donation. His study appears in the Canadian Journal of Anesthesia.
“I would say the idea of brain death is relatively complex,” he said, adding that “death is socially determined.” Relatives often question whether brain dead really means dead, especially in cases where the heart is still beating. This casts doubt on whether a family member’s organs can be donated, even if an organ donation card has already been signed.
Bowman argues that the western, Cartesian idea “I think therefore I am,” means that when a person’s brain dies and they can no longer think, it is easier for westerners to view them as deceased. This, in combination with the Christian belief in the spiritual value of non-reciprocal giving means westerners are more likely to see organ donation as worthwhile and valuable. Since in Canada most organ donations come from the deceased, perspectives on organ donation have an important impact on our health care system.
In contrast, members of other cultures do not all see organ donation as justifiable. For example, organ donation was not at first well-accepted in Japan, where the first physician to attempt a heart transplant was charged with homicide. Bowman argues that it is difficult to predict how other cultural perceptions will affect organ donation, especially since each culture’s view of death is different.
While in the past, it was believed that non-westerners’ lack of willingness to donate organs was due to a lack of education. Bowman argues that the issue is more complex.
“Cultural differences regarding organ donation are not about a lack of education, but about deeper cultural beliefs. In Canada, we talk a great deal about the need for cultural sensitivity, but we have been very slow to rise to the challenge,” he says. He claims that health care workers need a better understanding of other cultures to comprehend their perspective.
