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Organ procurement organizations Internet enrollment for organ donation: abandoning informed consent.

Woien S, Rady MY, Verheijde JL, McGregor J - BMC Med Ethics (2006)

Bottom Line: The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20-47), 79% (57-86), and 75% (50-100), respectively.The informed consent score was 0% (0-33).The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05).

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Affiliation: Department of Critical Care Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA. Rady.Mohamed@mayo.edu.

ABSTRACT

Background: Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent.

Methods: An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent.

Results: There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20-47), 79% (57-86), and 75% (50-100), respectively. The informed consent score was 0% (0-33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing.

Conclusion: The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent.

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Median donor knowledge scores of Web sites established by organ procurement organizations within the 11 United Network for Organ Sharing (UNOS) regions in the United States. The error bars show interquartile ranges.
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Figure 2: Median donor knowledge scores of Web sites established by organ procurement organizations within the 11 United Network for Organ Sharing (UNOS) regions in the United States. The error bars show interquartile ranges.

Mentions: Analysis of the content scores of the Web sites and consent forms by UNOS region are depicted in Figures 2, 3, 4, 5. The content scores for donor knowledge (Fig. 2) and informed consent (Fig. 5) were equally low for all UNOS regions. The content scores for donor consent reinforcement (Fig. 3) and donation promotion (Fig. 4) were equally high for all UNOS regions.


Organ procurement organizations Internet enrollment for organ donation: abandoning informed consent.

Woien S, Rady MY, Verheijde JL, McGregor J - BMC Med Ethics (2006)

Median donor knowledge scores of Web sites established by organ procurement organizations within the 11 United Network for Organ Sharing (UNOS) regions in the United States. The error bars show interquartile ranges.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1764895&req=5

Figure 2: Median donor knowledge scores of Web sites established by organ procurement organizations within the 11 United Network for Organ Sharing (UNOS) regions in the United States. The error bars show interquartile ranges.
Mentions: Analysis of the content scores of the Web sites and consent forms by UNOS region are depicted in Figures 2, 3, 4, 5. The content scores for donor knowledge (Fig. 2) and informed consent (Fig. 5) were equally low for all UNOS regions. The content scores for donor consent reinforcement (Fig. 3) and donation promotion (Fig. 4) were equally high for all UNOS regions.

Bottom Line: The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20-47), 79% (57-86), and 75% (50-100), respectively.The informed consent score was 0% (0-33).The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Critical Care Medicine, Mayo Clinic Hospital, Phoenix, Arizona, USA. Rady.Mohamed@mayo.edu.

ABSTRACT

Background: Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent.

Methods: An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent.

Results: There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20-47), 79% (57-86), and 75% (50-100), respectively. The informed consent score was 0% (0-33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing.

Conclusion: The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent.

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