Attitudes and Willingness of Patients Toward Organ Donation and Distrust in the Health Care System: Insights from Turkish Family Physicians.

Abstract

Objectives: Organ transplant recipients express trust in their physicians with the phrase, "I entrust my life first to Allah and then to you." However, trust is not reflected in organ donor rates in Turkey despite the rising incidence of end-stage organ failures. The aim of this study was to map individuals' attitudes, willingness, and behavior toward organ donation, relationships with distrust in the health care system, religious aspects, and demographic variables.

Materials and methods: In a descriptive cross-sectional approach, a face-to-face questionnaire was issued to randomly selected 557 patients in family medicine clinics of 2 tertiary hospitals in Istanbul City. Positive and negative attitudes' subscales of the organ donation attitude scale and distrust in the health care system scale were used.

Results: The organ donation rate was 12.4%, and 37.9% of participants were willing to donate. A higher education level revealed higher rates of willingness but did not supply a higher donation rate (P = .001, P = .048). The liver was the organ with the most potential to donate (90.3%). The average positive and negative attitude scores toward organ donation were 48.10 ± 21.41 and 72.11 ± 26.47, highlighting negative tendency. The rate of refusals donated for religious reasons was 30.1%. It was observed that individuals who religiously refused organ donation were less willing to donate and showed higher distrust in the health care system (P < .001; P < .001), but they exhibited more positive and less negative donation attitude scores vs others (P < .001; P < .001). Approximately half of the participants reported awareness of organ donation law and brain death principles supporting a significantly higher donation rate (P < .001; P < .001).

Conclusions: Our findings highlight a crucial mismatch among willingness, attitudes, distrust, religious aspects, and actual behavior regarding organ donation. Strategically, educational materials and interventions on relevant laws, brain death principles, and reasons for becoming donors may be more effective than focusing solely on increasing donation rates.