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Impact of Cadaveric Organ Donation on Taiwanese Donor Families During the First 6 Months After Donation

From the School of Nursing (F.-J.S.) and the Departments of Urology (M.-K.L.) and Surgery (S.-H.C.), College of Medicine, National Taiwan University; and the Departments of Nursing (M.-H.L., H.-Y.L., C.-I.T.) and Social Workers (L.-L.C.), National Taiwan University Hospital, Taipei, Taiwan.

Address reprint requests to: Shu-Hsun Chu, MD, FACC, FICS, Director, Far Eastern Memorial Hospital, Panchiao and Professor, Department of Surgery, National Taiwan University Hospital, 7, Chung-Shan South Rd, Taipei, Taiwan (100). Email: femh100{at}ms2.hinet.net

OBJECTIVE: Organ donation is a complex decision for family members of Asian donors. The impact of cadaveric organ donation on both Chinese and Western donor families has not been well investigated within a cultural framework. The purposes of this study were to follow Chinese family members’ appraisal of their decision to donate organs, to explore the possible negative and positive impacts of organ donation on their family life, and to determine what help they expected from healthcare providers during the first 6 months after donation.

METHODS: Twenty-two family members (10 men and 12 women) of cadaveric organ donors who signed consent forms at an organ transplant medical center in Taiwan participated in this project and completed in-depth interviews during the sixth month after donation.

RESULTS: Participants were 25 to 56 years old (mean = 48.15 ± 8.31 years). The type of kinship of the participants included the donor’s parents, older sister, and spouse. Subjects reported several negative impacts: worry about the donor’s afterlife (86%), stress due to controversy among family members over the decision to donate (77%), and stress due to others’ devaluation of the donation (45%). Positive impacts reported by the subjects included having a sense of reward for helping others (36%), having an increased appreciation of life (32%), having closer family relationships (23%), and planning to shift life goals to the study of medicine (9%). Subjects expected the transplant team to provide information about organ recipients (73%), to submit the necessary documents so that family members could receive healthcare payments from the insurance company (68%), to help resolve legal proceedings and settlements associated with accidents (64%), and to not overly publicize their decision to donate (64%).

CONCLUSIONS: Although all of the subjects reported that organ donation was the right decision, the decision to donate did not protect Taiwanese donor families from negative psychocognitive bereavement. The impacts of organ donation were affected by the subject’s social cultural, spiritual, and legal context and the nature of their bereavement.

Key Words: cadaveric organ donation • impact • families • Taiwanese culture.

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