Public Information Campaigns for Live Kidney Donation

Introduction: The Kidney Donation Deficit

The issue of organ donation is rife with bureaucratic difficulties. The significant deficit between what is needed and what is available to the medical community has created a highly deficient waiting-list system, in which would-be recipients are in a slow race against pressing health ailments that require timely organ transplant. This is the imperative driving a need for the more aggressive courtship of live kidney donation, which — due to its feasibility for the living donor and its significantly better outcomes for the patient — is the preferred method of treatment for those with critical renal issues.

Research tends to endorse this need by indicating that a significant portion of late-stage renal failure cases absolutely require kidney transplant as a life-saving measure. As MNT (2008) reports, "38% of all kidney transplants in the U.S. are now performed using living donors" (MNT, p. 1). This is an important point to draw upon as we enter into a broader discussion concerning the courtship of donors. The dissemination of information required to encourage more live kidney donation is rife with ethical concerns, particularly over the implications surrounding financial compensation for kidney donation, which threatens to exploit the critical monetary needs of the poor in order to improve the health of those wealthy enough to pay.

Means of Dissemination and Donor Incentives

Though deeply controversial, one of the most effective ways to encourage live kidney donation is through an evaluation of certain donor incentives. In terms of disseminating information, the attachment of a public health campaign to indications of specific donor incentives will be distinctly effective in generating attention from the right parties. This is underscored in a study by Kranenburg et al. (2008), which recognized that this approach may be received poorly by a public with practical and ethical apprehension about just such a system. The study therefore endeavors to determine the level of public acceptance for different measures of compensation to donors.

Public Acceptance of Compensatory Incentive Models

Specifically, the study measures public opinion concerning two scenarios: one in which the kidney donor is given a fixed financial compensation, and one in which the donor is provided with health insurance coverage for life. According to the findings, "although almost half of the respondents (46%) were reluctant towards introducing a system with fixed compensation to increase the number of living kidney donors, still 25% of the general public reacted positively" (Kranenburg et al., 2008, p. 1039). Moreover, the response was reported as significantly more favorable in contexts where health insurance for life would be offered, suggesting that respondents viewed this approach with less ethical apprehension. But even where ethical apprehension was more likely — as with the offering of direct financial compensation — respondents demonstrated a sufficient degree of support to suggest that public will may exist to permit such an approach.

Without remarking upon the legal intricacies of such an approach, the findings by Kranenburg et al. provide a basis to contend that some portion of the public would be reachable through either of the methods measured. Particularly compelling is the finding that 5.5% of respondents expressed a strong interest in participating in a donor program that would compensate them with healthcare coverage for life. This offers an impetus to disseminate nursing research findings through health insurance companies and medical facilities with a vested interest in matching donors and recipients. The study underscores the presumption that, where public health information campaigns are concerned, information is often accessed but then forgotten or ignored. By connecting this information to certain compensatory incentives, those who comprise a likely donor population may be more inclined to retain and return to the information provided. Though controversial, this presents a realistic view of the motivations that might incline someone toward an act with significant personal and health-related implications.

Conclusion

Ultimately, the methods discussed here will not eliminate the controversy or apprehension surrounding this subject. However, the evidence does tend to suggest that they would improve the ability of the healthcare system to meet the needs of a greater number of transplant candidates.

References

Aghanwa, H. S., Akinsola, A., Akinola, D. O., & Makanjuola, R. O. A. (2003). Attitudes toward kidney donation. Journal of the National Medical Association, 95(8), 725–731.

Kranenburg, L., Schram, A., Zuidema, W., Weimar, W., Hilhorst, M., Hessing, J., & Busschbach, J. (2008). Public survey of financial incentives for kidney donation. Nephrology Dialysis Transplantation, 23(3), 1039–1042.

Medical News Today (MNT). (2008). Kidney donation websites raise ethical concerns — public solicitation for organs may favor white, educated and wealthy recipients. Wiley Blackwell Publishing. Retrieved from