Organ Donation, Transplantation and Religion

Michael Oliver; Alexander Woywodt; Aimun Ahmed; Imran Saif

Disclosures

Nephrol Dial Transplant. 2011;26(2):437-444. 

In This Article

Abstract and Introduction

Abstract

Religious concerns may be an important reason why patients decline listing for a renal transplant. These issues may be equally, or even more, important when live donation is discussed. There is good reason to believe that religious concerns play a significant role much more often than clinicians and transplant teams believe. The issue is certainly further compounded by the fact that a few, if any, patients come forward with their religious concerns, not least because issue of transplantation is new to them anyway and because they meet with transplant teams whom they do not know. Health professionals, on the other hand, may wish to avoid this sensitive issue altogether or may lack knowledge on religious issues pertaining to transplantation. Some may be entirely unaware. We encountered a case in clinic that revealed our remarkable lack of knowledge in this regard. Here, we aim to provide an overview on how the different religions view transplantation and organ donation, with an emphasis on practical points for health care professionals who are involved in transplant listing, organ donation and retrieval, and transplantation itself. Knowledge of these facts may provide a background to deal with these issues professionally and appropriately and to increase transplant numbers.

Introduction

There is good evidence that patients from indigenous and migrant ethnic minorities are more likely to develop end-stage renal failure but less likely to receive a renal transplant.[1] They are also typically less likely to receive a well-matched kidney since they are under-represented among deceased donors: in the UK, only 5.1% of deceased kidney donations during the financial year 2008/2009 were from non-white donors, although a quarter of patients on the waiting list were non-white.[2] Unfortunately, low rates of live donation among ethnic minorities have been described as well.[3] Recent studies suggest that, apart from cultural, social and educational issues and language barriers, religious concerns may also play a role in a decision against donation.[4] However, care must be taken not to equate ethnicity with religion, and detailed analysis is required to dissect the various factors. There are also striking differences between countries as to the willingness to donate (Table 1). Some of these differences may be explained by different infrastructure, law or consent system, but religious factors may play a role as well, particularly in countries with low deceased donation rates.[5] We recently encountered a case in our clinic that made us rethink our approach to this issue, particularly in the large numbers of Muslim patients we see in our catchment area in the North West of England. In this review article, we first explore the Islamic view of organ donation and transplantation. We then provide an overview on how the other major religions view this topic, starting with the two other Abrahamic faiths (Christianity and Judaism), then moving on to the two major religions in India (Hinduism and Sikhism) and then to the religions of East Asia (Buddhism, Confucianism, Shintoism and Taoism). Finally, we discuss the issue of directed donation and religion.

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