BEM Organ Donation Awareness workshop was devoted to addressing the problem of low rate of organ donation among the Black Africa, Caribbean and Asian groups in Essex and to raise awareness of issues pertaining to clinical, cultural and religious values among the BEM and the mainstream communities. The workshop determined whether issues of cultural, economic, social and religious values differences have impacted or influence on organ donation sign-up rate among the BEM community.

1. EBEMRC
Essex Black & Ethnic Minority Research
Centre
BEM ORGAN DONATION AWARENESS
WORKSHOP PROCEEDINGS
By
Osarumwense Iguisi, PhD
166 Knights Way, Brentwood-Essex, CM13 2ER, UK T: +44 (0)1277 229122 M: +44 (0)7981990263
Email: info@ebemrc.org.uk www.ebemrc.org.uk Charity Registration No. 1135332

2. EBEMRC
Essex Black & Ethnic Minority Research Centre
BEM BLOOD AND ORGAN DONATION AWARENESS WORKSHOP
Held in Brentwood, Essex 25 September 2010
Appreciation______________________________________________________
BEM Organ Donation Awareness workshop was devoted to addressing the problem of low
rate of organ donation among the Black Africa, Caribbean and Asian groups in Essex and to
raise awareness of issues pertaining to clinical, cultural and religious values among the BEM
and the mainstream communities. The workshop determined whether issues of cultural,
economic, social and religious values differences have impacted or influence on organ
donation sign-up rate among the BEM community.
This document is a compilation of summary record report of papers, which were presented at
the workshop.
2

3. The workshop LOC wishes to express their appreciation of the active participation in the
organisation of the workshop, of the Executive Committee and members of the workshop
committee, Dr Valentine Ohakwe, Ms Winfred, Kwasi, Dr Evelyn Egbeokaruwa Ogbebor,
Phil Rufus and the workshop volunteers for a job well done. On behalf of the senior
management and staff of EBEMRC, the workshop masters of ceremony, associates and
collaborators in Essex County and beyond, the Executive Director of EBEMRC Dr
Osarumwense Iguisi expressed his thanks to the sponsor of the workshop, the Big Lottery
Fund for the planning, funding and effective execution of the workshop. EBEMRC
management wish also to thank Anne Milton MP, Parliamentary Under Secretary of State for
Public Health for her encouraging moral support and suggestions for workshop human
resources, which were a great tower of strength for the workshop and Mike Le-Surf for his
moral support for the workshop.
We wish to thank Pastor Peter Jordan for his active participation and granting permission to
use his church, Sawyers Church Hall, and his frontline administrative team for their selfless
contribution to the success of the workshop.
We are very grateful to the distinguished Masters of Ceremony Dr Emmanuel Okoro and
Barrister Mrs Pat Ohakwe for their effective and constructive management of the paper
presentations and workshop activity sections. We are very grateful to the different speakers;
Professor Gurch Randhawa, Director of Institute for Health Research of the University of
Bedfordshire; Dr Stephen Ogbonmwan, a Consultant Gynaecologist from Manchester;
Sharon Platt-McDonard, Director of Health Ministries/Disability Awareness, and British
Union Conference of Seventh-Day Adventists; Michelle Tyler, Team Manager NHS Easter
Organ Donation Services, Thomas Halley of Sawyers Church; Kala Mistry and Kirit Modi
who were all chosen on the basis of their qualifications, experience and track records of
achievements. We have used professionals, scholars and organ recipients as presenter and
discussants to provide the compelling statistical, clinical, social, cultural and religious facts
and perspectives about organ donation and transplant. The presentations and discussions
provided some answers and awareness of the problems faced by the transplant community
and necessity for the black African, Caribbean and South Asian communities to be actively
involved in organ donation and transplant campaign to educate their communities in order to
sign up the organ register to save more lives.
We wish to place on record our sincere gratitude to all the workshop participants for their
active and constructive contributions in making the workshop a success as well as to
everyone who helped in its organisation. This workshop should be a challenge and
encouragement to all concerned BEM community members. We look forward to your giving
more support and greater participation to EBEMRC further organ donation awareness forums
and other projects in our quest to propagate activities that promote the socio-cultural,
socioeconomic and healthcare needs and challenges of the BEM groups.
Finally, we send our sincere gratitude to the Big Lottery Fund for the financial support given
to the workshop.
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4. SYNOPSIS OF WORKSHOP REPORT
Introduction
The BEM Organ Donation Awareness Workshop initiated and organized by Essex Black &
Ethnic Minority Research Centre (EBEMRC) sponsored by the Big Lottery Fund was held on
the 25th September 2010 in Brentwood at the Sawyers Church Hall.
The objective of the workshop was to bring together decision-makers, service providers,
professionals and the different BEM individuals, groups and organisations who have shared
interests in the healthcare needs and clinical, cultural and religious barriers faced by the BME
communities regarding organ donation. The workshop helped to dispel the cultural stigma
and superstition held by the different BEM communities to increase participation in organ
donation sign-up. The workshop educates, raised consciousness and increase awareness of
organ failure and transplant among the black African, Caribbean and South Asian population
from the BEM community about the problem faced by renal failure patient and the necessity
for community to be actively involved in the campaign to save more lives and to sign up and
donate organ. The workshop informed the participants that organ transplant would be
successful only if the donor came from the same ethnic group as the recipient so that there
was a better chance of a close match of tissue type and blood group between the donor organ
and organ recipient.
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5. 65 participants responded to the invitation, which had been sent to them on behalf of
EBEMRC by the Chairman of the Workshop Organizing Committee. The participants were
both from mainstream and BEM communities all over UK. The calibre of participants cut
across both the private and public voluntary organisations featuring medical doctors,
healthcare practitioners and administrators, nurses, lawyers, religious and faith leaders,
teachers and scholars from UK Universities and Institutions,
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6. Welcome Address by the Executive Director of EBEMRC
Dr Osarumwense Iguisi
The Sponsors of this workshop (The Big Lottery), EBEMRC, Ladies and gentlemen,
It is with gratitude that I welcome you all to this very important workshop on BEM Organ
Donation Awareness.
As we are all aware, discussions about organ donation is a difficult and often taboo subject of
discourse within the BEM communities, with a host of misconceptions.
My friend and colleague Mr Obi Francis Iroegbu developed renal failure five years ago. He
has been one of the fortunate ones and had a life saving kidney transplant early this year
2010. Having known Obi and witnessed the positive affect this organ transplant have had on
him and his family lives has been a huge influence on me and this therefore led to the
conception and development of this project.
At this moment in the UK there are more than 10,000 patients on the transplant waiting list.
Of these patients, over 10% are of BEM people from black African, Caribbean and South
Asian communities and are 3 times more likely to need transplant than the white population.
Organ donation rates continue to be low among black African, Caribbean and South Asian
groups, leading to disproportionate numbers awaiting transplants, longer waiting times and
problems of tissue matching
Chris Rudge of UK Transplant provides evidence that 23% of the people who are waiting for
a kidney transplant are from black African, Caribbean and South Asian minority ethnic
backgrounds and only 3% of organ donors come from that background.
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7. Professor Gurch Randhawa of the Institute for Health Research at the University of
Bedfordshire, and a lead speaker in this workshop today, reported that 20% of people on
waiting lists in the UK for organ transplants were from ethnic minority communities.
According to Randhawa, it was often the case that a transplant would be successful only if
the donor came from the same ethnic group as the recipient so that there was a better chance
of a close match of tissue type and blood group between the donor organ and the recipient.
It has been argued that the lower rates of organ donation and transplantation in the black
African, Caribbean and South Asian populations are linked to this underrepresentation in the
donor pool.
The need for sustained and continuous awareness avenues to reach the BEM communities is
highlighted by some of the following facts:
• People from the BEM communities living in the UK are three times more likely to
need a kidney transplant
• There are currently 2,300 black African, Caribbean and South Asian members of the
community who are in need of a transplant
• But just 1.6 percent of people from the BEM community have joined the NHS Organ
Donor Register.
• A transplant is more likely to be successful if the donor and recipient are from the
same ethnic group
The facts from the above speak for themselves in making a compelling case for everyone to
become aware of the problems and to make an inform decision to join the NHS Organ Donor
Register. Of particular importance is the urgent call to members of the black African,
Caribbean and South Asian to take proactive action to join the organ donation register in
order to help save the lives of people who may otherwise die waiting for an organ transplant.
I am happy to tell you that we have here today in the workshop Mrs Kala Mistry and Mr Kirit
Modi, who are fortunate organ recipients and have come to share with us their experiences
and happy transplant stories.
Creating awareness and promoting effective community engagement and participation
forums for organ donation in a multicultural and multiethnic society represents one of the
major challenges facing the transplant community. Different communities cannot tackle
donor shortage in a standardised way, given the different attitudes, perceptions, religious and
cultural value concepts involved. Whatever the approach, there most be coordinated effort to
clear or demystify the misperceptions about organ donation in the BEM communities. Better
awareness and understanding of the cultural and religious influences would be a means of
building a strong support for transplantation and ensuring the success of organ donation
campaigns.
As well as increasing awareness about organ donation, the workshop aims to challenge the
misconceptions surrounding the issue through innovative use of community participation
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8. forums that will visit the different ethnic minority groups in their various local meeting places
around Essex in the coming months and years. These forums will support the decision-
making process by providing the community with unique insight into the experiences of
donor recipients’ and patients currently on the transplant waiting list as well as the
opportunity to see the positive impact of donation from donor family perspective.
Papers presented and discussed during the Workshop.
• Michelle Tyler: Statistical Facts on Organ Donation
• Professor Gurch Randhawa: Slideshow on ongoing Organ Donation and Transplant in
BEM Communities
• Kala Mistry: Life Testimony of an Organ Recipient
• Dr Stephen E.O. Ogbonmwan: Organ Donation Awareness among the African and
Ethnic Minority
• Sharon Platt-McDonald: Faith and Facts: Balancing Perspectives and Achieving
Engagement
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9. • Thomas Halley: Religious Perspectives on Organ Donation
• Kirit Modi: Life Testimony of an Organ recipient
9

10. Statistical Facts on Organ Donation
Michelle Tyler
Team Leader Eastern Organ Donation Services Team
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11. 11

12. 12

13. 13

14. 14

15. 15

16. 16

17. 17

18. 18

19. Slideshows on ongoing Organ Donation and
Transplant in BEM Communities Worldwide
Professor Gurch Randhawa
Presentation here
19

20. Organ Donor Recipient Testimony
Kala Mistry
Organ failure and transplants
Kidney failure (also called renal failure) is a term used to describe when a person's kidney
stops working properly, or fail. Renal failure can be divided into two categories: chronic renal
failure, and acute renal failure.
• Pain and red colour are symptoms of a skin burn.
• Vomiting and diarrhea are symptoms of cholera.
• Pain in the chest and cyanosis (blue colour of skin) are symptoms of heat disease.
• Headaches and nausea are symptoms of the flu.
Dialysis can be used for people who have become sick and have lost the use of their kidneys
for a short time, or for people who no longer have working kidneys. The purpose of the
kidney is to keep a balance of water and minerals in the body. These minerals include
sodium, potassium, chloride, calcium, phosphorous, magnesium and sulphate. The kidneys
also take out hydrogen ions from the blood. Dialysis is able to remove these wastes from the
body and help keep the minerals in balance
Types of dialysis – hemodialysis or peritoneal dialysis (PD)
Since you don’t have to schedule dialysis sessions at a center, PD gives you more control.
You can give yourself treatments at home, at work, or on trips. But this independence makes
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21. it especially important that you work closely with your health care team: your nephrologist,
dialysis nurse.
Transplants
Quite simply, it’s about how you can save lives by donating parts of your body.
Black people living in the UK are much more likely to need a kidney transplant than the
general population. This is because they are more likely to develop diabetes or high blood
pressure, both of which are major causes of kidney failure.
My story
I started feeling unwell around 1995 and was having a range of tests. I was blood test for
creatinine. Higher levels of creatinine indicate a falling glomerular filtration rate getting
suffering from headaches, tired easily, lethargic, heavy periods followed by depression and
lack of appetite. I was prescribed various antibiotics paracetamol etc.
It was in 1999 when, I went in for a minor operation and during routine checks that my high
blood pressure was identified. I was sent for tests to find out the cause of the high blood
pressure.
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22. My background history, family on both mother and father’s side were checked. There was no
family history and I was told I had suffered Chronic Renal failure which was progressive
loss in renal function over a period of months or in my case years.
Symptoms were: symptoms of a skin burn; Vomiting and diarrhea; Pain in the chest.
Generally feeling unwell and tired, unable to sleep or eat with terrible foul taste in the mouth.
I was guided through the different types of dialysis and chose peritoneal dialysis (PD). I
wanted control over my life and be able to lead a full life as much as possible.
I was seriously ill on my 50 th birthday, and all I wanted was a party for my birthday but this
could not happen. But my wonderful husband made sure it was a special day for me with
gifts,
Most important to be able to continue teaching which I worked hard to train and achieve
success. I worked closely with my dialysis nurse so I could give myself treatments at home,
at work, or on trips. I had a small dialysis machine at home that helped me to dialyse
overnight and next day to teach as normal. I did have to ensure I had enough fluid and did not
suffer cramps after the dialysis. I learnt the different gargons of reasons for blood test for
creatinine. Higher levels of creatinine indicate a falling glomerular filtration rate (kidney not
functioning well)
My name was placed on the organ register three months after i had been dialysing and had
been well. I was told i would have to wait 18 months to 2 years for an organ. In reality I did
not know that the organs for like me who are Indians, Black and ethnic minority people were
very rare and waiting time was very long.
My husband decided to go for tests when he saw there were times when I was struggling with
dialysis and losing my resolve to be independent.
One day I was off work not feeling 100% and decided to take time off to rest. I was resting
when I had the phone call. The caller told me that an organ was available for transplant and
would I be willing to accept it? I had to ask her to repeat twice before i understood what was
being said.
If so, I would need to make my way to royal London. I called my husband at work and
through his employer explained what was going to happen. Called my sons and informed
them that I was going for transplant.
When I reached London Barts they asked again tested for blood for me, my husband and then
the waiting started. They told me the kidney was 99% match and so would work very well.
The transplant took place during the night and took 3-4 hours.
Next day I was very drowsy but awake and doctors told me it was success. Blood tests done
daily, medication – feeling nausea, vomiting, taking large tablets. Not being able to eat or
drink.
Took 5-6 days when i started feeling better. Then i had to find out about the names of
medicine and when to have them.
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23. Changed one medicine cyclosporine from tablets to liquid. I was told by another patient to
take with juice stops being sick. The liquid is very expensive and only prescribed as a last
resort.
I did suffer infection had to stay in hospital for further 6 weeks to get better. Then the follow
up of visits three times a week for blood tests, urine tests and seeing the doctors.
It took 3-6 months for me to get better and fully recovered and back at work.
Now I do have to look after myself. I have a new goal and that is to help others understand
what this is. Encourage families to support the person suffering, become blood donors and
live organ donors and give a gift for life. I keep fit and healthy as much as possible, take part
in Transplant Games UK and meet other organ donors and share ideas.
My regime: regular medication, regular healthy eating, keeping fit physically and mentally
and listening to my doctors and following their instructions.
I could not have achieved this without the help, support and encouragement from my
husband, my children and my friends and family.
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24. 24

25. ORGAN DONATION AWARENESS FOR AFRICANS & ETHNIC MINORITIES
Dr Stephen E.O. Ogbonmwan, MBBS, M.MED, FMCOG, FRCOG.
Introduction
I am honoured to be invited to deliver this very important paper on this very important health
issue of organ donation and transplantation especially amongst Africans and other ethnic
minority in the United Kingdom. Although I do not work with organ donation I support good
health, longevity and high quality of life. What I am going to say today affects all Africans
where ever they may live on the globe and in fact all of mankind. This is a story of love and
support for each other.
You must forgive me as I am going to use the word African rather than the word Black or
Black African as advertised because I do not believe in colour coding of any race.
There is no doubt there is increased need for organ donation and transplantation in the world
today due to sophistication of science and medical treatment. To use stem cell for everyday
treatment of diseased organs will take many more decades so organ donation and
transplantations will continue to hold the pride of place for a long time.
Organ transplantation is the surgical removal of a tissue or organ from one individual (dead
or alive) and the placement of that organ in another individual for the purpose of improving
the health of the recipient. Most transplant programme depends on either cadaveric or living
organ donation. There is scarcity of human organs for transplantation so many patients face
imminent death or long suffering.
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26. Organ donation and transplantation creates a culture of life and love. Many religious and
secular approaches justify organ donation and transplantation because it promotes life. The
Catholic Church for example favours it, especially in the encyclical Evangelium Vitae, which
states that ‘organ donation is an act of the virtue of charity’. My speech will dwell on the
promotion of organ donation and transplantation. We shall look at the scale of the problem
amongst Africans, religious, social, cultural, legal and ethical aspects of organ donation and
inform on how Nigerians especially the Benin (Edo speaking people) of Southern Nigeria
believe, and the final section is on the promotion of organ donation and transplantation.
Scale of the Problems
10,000 people in UK are in need of organ transplant to save or enhance their lives. Organ
donation rates are relatively low amongst Africans and African-Caribbean’s.
The African is 3 times more likely to need a kidney transplant than the Caucasians
population.
A total of 23% of the people who are waiting for an organ transplant are Africans & Afro-
Caribbean and South Asian ethnic minority groups.
Only 3% of organ donors come from African background. The huge disparity between need
and organ donation is very apparent.
Africans do badly in all health Indices.
• Mothers of African ethnic origin are 2.3 times more likely to have a stillbirth at parturition.
• They are 2.3 times more likely to have a neonatal death than mothers of Caucasian origin.
• Research has shown that non-Caucasians women are one and half times more at risk
of experiencing severe pregnancy-related complications than Caucasian women.
• This risk doubles for African women especially African-Caribbean women.
• The overall estimated risk of severe complications is 89 cases per 100,000 maternities
in the UK.
• For Caucasian women this risk is around 80 cases per 100,000 maternities. It is 126
cases for non-Caucasian women as a whole,
• But it is 188 cases of severe complication per 100,000 maternities for African women.
• Worse still it is 196/100,000 maternities for African Caribbean women.
You can see that the African do badly in all health indices which is a cause for serious
concern and should be a cause for serious concern in the African community.
The way forward is Education, education and education, interaction, change of attitude and
participation.
The History of Organ Transplant
Scientists have long thought about the idea of replacing a diseased organ with a healthy one
from a donor. The problem at first was that the human body is not particularly receptive to
foreign tissue. The immune system is like an army, constantly on guard against any invasion
of bacteria viruses or other potentially dangerous substances. When tissue from a donor is
placed inside the body of a recipient, this immune army sees it as a foreign invader and goes
into battle mode. White blood cells attack and destroy the unknown tissue in a process known
as rejection.
26

27. Scientists subsequently realized that the problem of rejection didn't occur when the organ
donor and recipient were identical twins. The genetic similarity appeared to prevent the
immune response. Massachusetts surgeon Joseph E. Murray used this concept to his
advantage in 1954, when he accomplished the first successful kidney transplant between
identical twins at Brigham and Women's Hospital in Boston USA.
Dr. Murray's surgery was a major breakthrough, but it wasn't a solution. After all, very few
people have an identical twin they can rely on for organ transplantation. In the late 1960s,
doctors figured out a way to perform transplants between non relatives by suppressing the
recipient's immune response with drugs like cyclosporine. The trouble was that the drugs
themselves were highly toxic. Due to the risks of infection and those of the
immunosuppressant drugs, most transplant patients didn't live long after their operation.
By the 1980s, anti-rejection drugs had improved to the point where transplantation surgery
became pretty routine and far less risky than it had been a few decades earlier. Survival rates
rose. Once surgeons had streamlined the process of transplanting essential organs like hearts,
kidneys, liver and lungs -- they turned their focus to "nonessential" parts of the body. In the
late 1990s, surgeons in Lyon , France and New Zealand performed the first successful hand
transplants. The next step was to attempt a face transplant.
Religious aspects of Organ Transplant:
All the major religions of the UK support the principles of organ donation and
transplantation. However, within each religion there are different schools of thought, which
mean that views may differ. All the major religions accept that organ donation is an
individual choice.
The following information comes from the NHS leaflet which offers a brief guide to religious
viewpoints regarding organ donation. If you have any doubts, you should discuss them with
your spiritual or religious leader.
Buddhism & Organ Donation:
There are no injunctions in Buddhism for or against organ donation.
The needs and wishes of the dying person must not be compromised by the wish to save a
life. Each decision will depend on individual circumstances.
Central to Buddhism is a wish to relieve suffering and there may be circumstances where
organ donation may be seen as an act of generosity. Where it is truly the wish of the dying
person, it would be seen in that light.
If there is doubt as to the teachings within the particular tradition to which a person belongs,
expert guidance should be sought from a senior teacher within the tradition concerned.
When he discovered a monk sick and uncared for, the Buddha said to the other monks,
"Whoever would care for me, let him care for those who are sick".
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28. Christianity & Organ Donation
The Christian faith is based upon the revelation of God in the life of Jesus Christ. Throughout
his life Jesus taught people to love one another and he proved his love for the world upon the
cross. It seems in keeping with this that Christians consider organ donation as a genuine act
of love and a way of following Jesus’ example. This act of love then becomes part of a
Christian discipleship or faith journey that is motivated by compassion to help someone else
and demonstrates a sense of social responsibility.
Sacrifice and helping others are consistent themes in Christianity, which teaches the principle
of seeking for others what you hope others would do for you. Enabling life to be lived as
fully as possible is consistent with the teaching of the Son of God, Jesus Christ: “...freely you
have received, freely give” Matthew, chapter 10:8
Christians should be encouraged to help others in need. Discussing organ donation with
family and friends is a responsible and thoughtful act.
Hindu & Organ Donation
There are many references that support the concept of organ donation in Hindu scriptures.
Daan is the original word in Sanskrit for donation meaning selfless giving. In the list of the
ten Niyamas (virtuous acts) Daan comes third.
Life after death is a strong belief of Hindus and is an ongoing process of rebirth. The law of
karma decides which way the soul will go in the next life.
Organ donation is an integral part of the Hindu way of life, as guided by the Vedas. That
which sustains is accepted and promoted as Dharma (righteous living). Scientific treatises
form an important part of the Vedas – Sage Charaka deals with internal medicine while Sage
Sushruta includes features of organ and limb transplants.
“...it is said that the soul is invisible...knowing this you should not grieve for the body.”
Bhagavad Gita, chapter 2:25
Islam & Organ Donation
In 1996 the Muslim Law (Shariah) Council UK issued a fatwa (religious opinion) on organ
donation. The council resolved that:
• the council supports organ transplantation as a means of alleviating pain or saving life
on the basis of the rules of the Shariah
• Muslims may carry donor cards
• the next of kin of a dead person, in the absence of a card or an expressed wish to
donate their organs, may give permission to obtain organs from the body to save other
people’s lives.
The fatwa is based on the Islamic principle of necessities overrule prohibition. Normally,
violating the human body, whether living or dead, is forbidden in Islam – but the Shariah
believes this can be overruled when saving another person’s life.
However there are also a significant number of Muslim scholars who believe that organ
donation is not permissible and hold the view that this does not fall under the criteria of the
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29. Islamic principle of necessities overrule prohibition due to other overriding Islamic
principles.
Both viewpoints take their evidence from the Qur’an and the Ahaadith and therefore
individual Muslims should make a decision according to their understanding of the Shariah or
seek advice from their local Imam or scholar.
The Muslim Law Council UK fatwa draws on one of the basic aims of the Muslim faith:
saving life.
“Whosoever saves the life of one person it would be as if he saved the life of all mankind.”
Holy Qur’an, chapter 5:32
Judaism & Organ Donation
In principle, Judaism supports and encourages organ donation in order to save lives (pikuach
nefesh).
This principle can sometimes override the strong objections to any unnecessary interference
with the body after death, and the requirement for immediate burial of the complete body.
As all cases are different, Jewish law requires consultation with a competent Rabbinic
authority before consent is granted.
For more information please contact the Office of the Chief Rabbi, or another competent
Halachic authority.
“One who saves a single life – it is as if he has saved an entire world.” Pirke D’Rav Eliezer,
chapter 48
Sikh & Organ Donation
Sikh philosophy and teachings place great emphasis on the importance of giving and putting
others before oneself.
It also stresses the importance of performing noble deeds and there are many examples of
selfless giving and sacrifice in Sikh teachings by the ten Gurus and other Sikhs.
Sikhs believe life after death is a continuous cycle of rebirth but the physical body is not
needed in this cycle – a person’s soul is their real essence. “The dead sustain their bond with
the living through virtuous deed.”
The transplantation of organs from living donors is morally permissible when such a donation
will not sacrifice or seriously impair any essential bodily function and the anticipated benefit
to the recipient is proportionate to the harm done to the donor. Furthermore, the freedom of
prospective donor must be respected, and economic advantage should not accrue to the donor
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30. No religion formally forbids donation or receipt of organs or is against transplantation from
living or deceased donors. Only some orthodox Jews may have religious objections to
“opting in.” However, transplantation from deceased donors may be discouraged by Native
Americans, Roma Gypsies, Confucians, Shintoists, and some Orthodox rabbis.
No religion formally obliges one to donate or refuse organs
No religion formally obliges one to consider cadaveric organs “a societal resource” or
considers organ donation “a religious duty” (except some rabbis and isolated Muslim and
Christian scholars)
No religion has a formal position on “bonus points,” which is priority on the waiting list.
Living organ donation is strongly encouraged only between Jesus Christians (15 of 28 Jesus
Christians worldwide have donated a kidney). No religion forbids this practice.
No religion prefers cadaveric over living donation.
No religion formally forbids non–heart-beating donors (nhbd) cadaveric donation or cross-
over donation. Due to the sacred of human life, the Catholic Church is against donation from
anencephalic donors or after active euthanasia.
No religion formally forbids xenotransplantation. Addressing the participants of the First
International Congress of the Society for Organ Sharing in 1991, Pope John Paul II said
“There are many questions of an ethical, legal and social nature which need to be more
deeply investigated. There are even shameful abuses which call for determined action on the
part of medical association and donor societies, and especially of competent legislative
bodies” and later on “In effect, the human body is always a personal body, the body of a
person. The body cannot be treated as a merely physical or biological entity, nor can its
organs and tissues ever be used as item for sale or exchange”.
Addressing the participants at the XVIII International Congress of the Transplantation
Society in 2000, Pope John Paul II said “Accordingly, any procedure which tends to
commercialize human organs or to consider them as items of exchange or trade must be
considered morally unacceptable, because to use the body as an object is to violate the dignity
of the human person” and later on added “The criteria for assigning donated organs should in
no way be discriminatory (i.e. based on age, sex, race, religion, social standing, etc.) or
utilitarian (i.e. based on work capacity, social usefulness, etc.).” To conclude, according to
the Catechism of the Catholic Church Compendium signed by Pope Benedict XVI on June
28, 2005, 476.
Organ transplantation is morally acceptable with the consent of the donor and without
excessive risks for him/her. For the noble act of organ donation after death, the real death of
the donor must be fully ascertained.
Social and cultural aspects of organ donation
In Asian countries, it is more difficult to obtain cadaver kidneys for renal transplantation
because of certain socio-cultural beliefs and customs. The issues affecting living related
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31. kidney donation are more social than cultural. This is due to the web of family pressures and
personal conflicts for both donor and recipient surrounding the donation. Important
misconceptions and fears are:
• fear of death,
• the belief that removal of organ violates sanctity of decreased,
• concern about being cut up after death,
• desire to be buried whole,
• dislike of idea of kidneys inside another person,
• wrong concept of brain death, and
• the idea of donation being against religious conviction.
In Singapore, with the introduction of the Human Organ Transplant Act (HOTA) in 1988, the
numbers of cadaveric transplants have increased, including those from the Medical Therapy
Act (MTA). HOTA and education have played pivotal roles in bringing about an increased
yield of cadaveric kidneys. With the availability of living unrelated donor (LUD) transplants
in India, our living related donor (LRD) transplant programme has suffered, because patients
would rather buy a kidney from overseas than get a relative to donate one. Patients are also
going to China for overseas cadaveric transplants where the kidneys come from executed
convicts. People in countries like Hong Kong, Japan and the Philippines share the same Asian
tradition of not parting with their organs after death. Muslim countries like Malaysia require
the deceased to have earlier pledged his kidneys for donation prior to death before they can
be harvested for transplantation at death.
Benin (Edo Speaking) People of Southern Nigeria
The Benin or Edo speaking people of Southern Nigeria, see the body as sacred and not to be
dismembered or violated. Liken that to the biblical teaching which says the body is the
temple of the Lord and should not be dishonoured by dismembering it at donation. The Benin
people believe in reincarnation that the body is only a vehicle for the soul or human spirit.
Hence they comfort the relatives of the deceased that the deceased is not dead but has only
transcended this life as his/her soul has gone beyond human perception. ‘wa ghe vie ba
mwen no wu’ That transcended soul reincarnates 14 times to atone for perceived sins before
going into sublimation or eternity. It is believed that a dismembered part may be missing in
subsequent reincarnation which how the people explain birth defects. These ancient and
traditional beliefs are gradually giving way to modern thinking that organ donation saves and
prolong the lives of the recipient and as such should be encouraged. However the fear of the
unknown keeps holding people back from doing the needful in organ donation.
Medical Aspects of Organ Donation and Transplantation
Living organ donation has advantages from an immunological point of view because there is
often a large degree of similarity between the tissue types of the donor and the recipient. 1
However, we cannot fully avoid the risks to donors and recipients.2
Many of the studies report only minor risk to the donors, but earlier there was anxiety
concerning risks to the donors. Today one can find a much more positive attitude towards
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32. living organ donation. It is noted that in the case of a living donor, mortality after surgery is
extremely low. For instance, a survey of U. S. kidney transplants shows that there are only 5
donor deaths in 19,368 live kidney transplants. 3 Patients who decide to undergo
transplantation are subject to normal surgical risks. There are also complications of urological
and vascular problems, especially with regard to kidney transplantation. 4 Besides,
transplantation affects the recipient body's structure. The main benefit to the recipient is that
he/she gets a new lease on life or even a better quality of life.
Legal Aspects of Organ Donation and Transplantation
Due to the illegal medical practice in transplantation, commercialization of human organs and
so on, many countries formulated transplantation laws. The status of transplantation law can
be divided into three groups: opting-out, opting-in, and required request.
• According to the opting-out system, every human being is considered a possible
donor after death unless he/she has officially expressed a contrary option. It is also
known as presumed consent.
• By opting-in we mean a process by which people voluntarily sign and submit a will
saying that they want to become donors once they are dead. If they do not do this,
they will not be legally considered donors.
• Required request law requires hospitals to ask the family of a deceased patient for a
donation of organs and tissue if the deceased is a suitable candidate for organ
donation.7
Many countries have either enacted or are in the process of drafting legislation to control the
area of living donor transplantation. Although the general field of transplantation is still in a
state of change and growth, the fundamental legal issues that must be confronted remain
unchanged. There have been recent developments in legislation, especially giving priority to
the genuine consent of the donor. Although the majority of legislation has been written for
cadaver organ donation, slowly, regulation is developing for living organ donation as well.
The clauses of the laws are made on the basis of medical, ethical, religious, social and
cultural considerations.
In most countries, the law prohibits trade in human organs and address the donor's right, the
adequate supply of organs to the needy, the optimization of transplantation costs and the
promotion of transplantation procedures.
Ethical Issues in Organ Donation and Transplantation
The practices of organ donation and transplantation raise many ethical questions. How can
we morally justify organ donation and transplantation? What are the ethical issues connected
with the donor, with the recipient, and xenotransplantation?
Catholic Church holds that the virtue of charity is the norm for the justification of the
cadaveric and living organ donation and transplantation. Pius XII in his address to
ophthalmologists in 1956 argues that acts of donation cannot be viewed as a duty or as
obligatory. Such acts are supererogatory and not obligatory.
32

33. Moreover, John Paul II justifies organ donation and transplantation based on charity in
general. In the address on blood and organ donations of August 1984, John Paul II
commended the National Association of Italian volunteer blood and organ donors for their
spirit and initiative. He urged them "to promote and encourage such a noble and meritorious
act as donating your own blood or an organ to those of your brothers and sisters who have
need of it.’’
In addition, in an address to a Congress on Renal Illness and Transplants (April 30, 1990), he
speaks about the Church's main concern for renal illness and donations. The Pope asks the
directors of Catholic institutions to encourage this generous act of organ donations: "Those
who believe in our Lord Jesus Christ, who gave his life for the salvation of all, should
recognize in the urgent need for a ready availability of organs for renal transplants a
challenge to their generosity and fraternal love.’’
Further, in his address to the participants of the first International Congress of the Society for
Organ Sharing (June 20, 1992), the Pope considered organ transplantation as a new way of
serving the human family. In organ transplantation man/woman has found a way to give
himself/herself, in blood and body. This gesture allows others to continue to live.
This gift is actually an authentic form of human and Christian solidarity. Similarly, John Paul
II writes in Evangelium Vitae no. 86 that organ donation is an act of love when it is done in
an ethical manner. The death and resurrection of Jesus Christ establishes the supreme act of
love. This extends a deep meaning to the donor's offering, which is saving the life of another
person. Love (charity) constitutes the main element in organ donation and transplantation,
especially in the case of the organ donor.
Moreover, other religions also support organ donation and transplantation even if their point
of emphasis is slightly different.
• In Judaism, Rabbi R. P. Bulka observes: "One may laud the donor who makes ... a
heroic sacrifice, but it certainly would not be proper to place pressure on individuals
to be so altruistic."
• Greek Orthodox Church, Stanley S. Harakas writes about the donation of a kidney.
Organ donation rescues "the life of another person as a loving act of mercy. The
donor is to be commended if he perceives his sacrifice not as a violation of his bodily
integrity, but as a gracious and loving unselfish act."
• Quoran and Hadith (the Prophet Mohammed's sayings and examples), the Islamic
Code of Medical Ethics (1981) upholds: "If the living are able to donate, then the
dead are even more so; no harm will afflict the cadaver if the heart, kidneys, eyes or
arteries are taken to be put to good use in a living person. This is indeed charity."
• In the Buddhist tradition, organ donation is an act of helping another person in his/her
extreme need. It is an act of generosity and compassion. Organ donation and
transplantation is acceptable also in the Hindu tradition.
Care for the other and altruism are the secular terms that we can find in the literature on organ
donation and transplantation. Even if many use these terms, the basic idea behind them is
33

34. charity. Here, care for the other or altruism in organ donation is not self-sacrifice alone, but
there is sufficient self-concern for one's own self. Many scholars justify organ donation on
the basis of altruism, charity, love or care for the other. From what has been stated there is no
moral obligation for organ donation. The virtue of charity is the main motive for it.
According to the Catholic perspective, donors can donate organs except brain and
reproductive organs. The brain is significantly determinative of personal identity. The
reproductive organs are associated with reproductive identity. Neither the brain nor the
reproductive organs may be procured from human beings or animals for transplant to a
human person (Evangelium Vitae no. 63).
Church also holds that "to take tissue from a live foetus for transplantation is unethical"
(Evangelium Vitae no. 63). Great concern must be given to ensure that all cadaveric foetal
tissue to be used for transplantation is derived from natural miscarriages or from ethically
obtained cell lines.
Commercialisation has a serious negative impact on many of the medical and ethical values
intimately connected with organ transplantation. The Catholic Church is against paid organ
donation. Parts of the human body are not to be treated as commodities. Trade in human body
parts is unacceptable, as in any other disrespectful use of the organs or tissues of a living or
deceased person. At the World Congress of the Transplantation Society (Rome-2000), John
Paul II said "any procedure which tends to commercialize human organs or to consider them
as items of exchange or trade must be considered morally unacceptable, because to use the
body as an "object" is to violate the dignity of the human person." Paid organ donation
spoils the spirit of altruism. In paid organ donation, one does not fully respect the other.
Ethical Issues Connected With Donor
The main ethical concerns related to living organ donation include functional integrity, and
the consent of the donor.
Catholic Church has used the principle of totality for the justification of living organ donation
and transplantation. A simple expression of the principle of totality means, "the parts of the
physical entity, as parts, are ordained to the good of the physical whole. "From the medical
perspective, the principle of totality would mean "all the parts of the human body, as parts,
are meant to exist and function for the good of the whole body, and are thus naturally
subordinated to the good of the whole body." The term "totality" points to the duty to preserve
intact the physical component of that integrated whole. The official statement of the Church
regarding the application of the principle of totality to medical problems can be seen mainly
in the period of Pius XII. He reaffirmed, clarified, and applied the principle of totality to
medico-moral questions in many addresses delivered from 1944-1958. According to him, "a
part of the body has no meaning outside its reference to the whole that as a part is to be
thought of only in relation to the whole."
Understand the difference between functional integrity and anatomical integrity. One must
distinguish between the good of the adequately functioning body and the good of the full
integrity of the anatomical whole." The principle of totality is concerned with the former and
not the latter.
34

35. Ashley & K. D. O'Rourke presents their own formulation of the principle of totality and calls
it the principle of “Totality and Integrity.' It reads as follows:
"Except to save life itself, the fundamental functional capacities which constitute the human
person should not be destroyed, but preserved, developed, and used for the good of the whole
person and of the community." On the one side this principle grants priority for some human
values over others. On the other side, it breaks the "fundamental integrity" of human person
for certain kind of worth, "except in the most extreme choice between life and death.’’
For Benedict M. Ashley and Kevin D. O'Rourke, organ transplants are justified when the
functional integrity of the donor is maintained. They give a summary of moral reflections on
living organ donation and they present certain principles for living organ donation and
transplantation:
• There should be a serious need faced by the patient, which can only be satisfied by
organ donation.
• Even if donation reduces "anatomical integrity, it should not diminish the "functional
integrity" of the person.
• The risk in donation as "an act of charity is [to be] proportionate to the good resulting
for the recipient."5
• There should be "free and informed consent" by the donor. All these norms can be
seen in the principle of totality.
The 1975 Ethical and Religious Directives for Catholic Health Care Facilities states "[T] he
transplantation of organs from living donors is morally permissible when the anticipated
benefit to the recipient is proportionate to the harm done to the donor." The Directives also
mention that the donations of organ should not reduce the "functional integrity" of one's
body. Moreover, the 1994 Directives, section no. 30 directly deals with the need of
safeguarding functional integrity in living organ donation and transplantation. It reads as
follows:
The transplantation of organs from living donors is morally permissible when such a
donation will not sacrifice or seriously impair any essential bodily function and the
anticipated benefit to the recipient is proportionate to the harm done to the donor.
Furthermore, the freedom of prospective donor must be respected, and economic
advantage should not accrue to the donor.
Informed Consent of the Donor
The informed consent of the donor is another key requirement in living organ and
transplantation. If donor's decision is not autonomous or self-determined this leads to treating
a person without respect. Respect for autonomy requires that the donor must be able to
exercise the power of free choice.
In the case of living organ donation, no physiological benefit is to be expected by the donor.
It is clear that the first matter of critical importance is how far the amount of risk, pain, and
length of incapacity is communicated to the donor so that an informed decision can be made.
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36. Art. 3 of the WHO Declaration states that "the donor should not be influenced or abused."
Organ donation, says John Paul II, is a free and conscious decision either on the part of the
donor, or of someone who legitimately represents the donor. It is also a decision of giving
without any remuneration. Really, donation concerns the well being of another person. It is
very difficult to make an assessment of fully informed consent of the potential donors,
especially in the case of prisoners, mentally challenged persons, and minors.
Cadaveric Organ Donation
The donation of organs and tissues after death is a generous act. With regard to the cadaveric
organ donation and transplantation, the main ethical issues include the concept of brain death,
and consent.
Ethical Issues Connected with the Recipient
There should be a proportionate relation between physical risk to the donor and good for the
recipient. The risk in donation as "an act of charity is [to be] proportionate to the good
resulting for the recipient." CCC no. 2296 states:
Organ transplants confirm with the moral law and can be meritorious if the physical
or psychological dangers and risks incurred by the donor are proportionate to the
good sought for the recipient. It is morally inadmissible directly to bring about the
disabling mutilation or death of a human being, even in order to delay the death of
other persons.
The general principle that surgery cannot be carried out without the consent of the person to
be operated upon is equally applicable to organ transplantation as well. Recipients also
should give their consent for the operation. The physician should inform the donor and the
recipient in an honest, appropriate and comprehensible manner of the possible risks of organ
donation and transplantation.
According to Catholic perspective "patients should be treated equally when being admitted to
transplant programmes. There should be no unjust discrimination on the basis of social
factors such as inability to pay, mental illness, past misuse of substances, lack of family
support, lack of education, advanced age, remoteness or ethnicity. Only clinical factors such
as urgency, need and ability to benefit should be taken into account.’’
Xenotransplantation
Transplantation of animal organs to human being is permissible provided the procedure will
not impair the integrity of the recipient nor impose inordinate risks on the recipient or others.
With regard to the animal-human hybridisation, Church says that "the introduction of parts of
the human genome into animal tissue or vice versa must not involve extensive animal-human
hybridisation, inheritable changes to a human being, or the formation of an organism
possessing some human and some animal material which may capable of further development
as an embryo."71
Promotion of Organ Donation and Transplantation
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37. The present state of organ donation and transplantation includes different types of
transplantation, different types of donations and one should consider also the medical, moral,
and legal problems connected with the practice of organ donation and transplantation.
Types of Transplantation
Auto grafts, isographs, homographs, and heterografts.
Auto graft (syngenic) is the transplanting of an organ or tissue within the same individual
from one part of the body to another.
Isograft (Isogenic) is the transplantation of organs or tissues between two genetically
identical individuals, such as identical twins.
Homograft (allogenic graft) is the transplantation of an organ from one individual to another
within the same species.
Heterograft (Xenogenic graft) is the transfer of organs between individuals of different
species, usually from animals to human beings.
Types of Donations
Cadaveric and living organs are the two main sources for transplantation.
The cadaveric donation includes related and unrelated donations.
There are five types of living organ donations:
- Living Related Donation: donation between genetically related persons,
- Living Unrelated Donation: donation between non-genetic or non-emotional persons.
There may be also emotionally related transplantations.
- Crossover Transplantation: In renal transplantation certain donors cannot donate their
organs to a particular recipient because of the ABO incompatibility and other
problems with histocompatibility (e.g. positive T-cell cross matches) but without any
ABO problem with other recipients (crossover transplantation). For instance, donor A
cannot give a kidney to recipient A but he/she can give it to recipient B. Similarly
donor B cannot give a kidney to recipient B; but he/she can donate to recipient A.
- Domino: in this programme an organ may be transplanted to a patient whose own
organ then still can help another patient on the waiting list.
- Indirect Living Organ Donation: close relative of a recipient wants to donate his/her
kidney to the donor. But this living related transplantation is not possible due to blood
group incompatibility. The recipient is then placed higher on the waiting list, while
the organ from the donor is added to the organ pool.
We have seen in the last section the ethical issues related to organ donation and
transplantation. The virtue of charity will be an important element in increasing organ
donation. This kind of value education can be promoted both by religious groups and by
secular agencies.
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38. This inter-human relationship is very clear in the case of organ donation and transplantation,
which expressed in the relation between donor and the recipient. It is not an "I-It"
relationship, but an I-Thou relationship. This means the donor is moved by the face of the
other (recipient) who is in a critical stage, which is helpless. The deep relationship shows the
empathy with the other. For instance, the French philosopher Merleau-Ponty writes:
- There is an essential relationship between body and consciousness such that the body
is never - even throughout transplant surgery - just a body, but rather a perceiving
entity, that is to say animate.
- Every body receives its specificity and becomes animate through the perception of
another.’’
Organ donation also highlights the value of solidarity in society, especially in medicine.
Organ donation points to a social dimension where donors and the recipients are part of the
society. The social aspect is also one of the elements that assist in making decisions in organ
donation and transplantation. The value of solidarity encourages the donors and recipients,
and others who participate in transplantation, to make responsible decisions. We also argue
that from a moral point of view, commercialisation of organs does not promote organ
donation and transplantation. Selling body parts for money reduces the value of the person.
There should be no material profit in charitable or altruistic organ donation. In the present
situation where we are facing a crisis of organ shortage, helping patients who are in a critical
stage, really shows the social character of the human person.
Conclusion
There is a real scarcity of human organs even though organ transplantation facilities are
widely available. In this context, both living and cadaveric organ donation and transplantation
should be promoted.
• African and ethnic minority should be encouraged to be involved in organ donation to
ease the waiting list of their kin men and women on the organ donation programme.
• Africans should do their best to be exposed to all available resources in the
environment in which they live so that they can utilise these resources to their fullest
advantage as well as contribute to it to make successful it for mutual benefit.
• Africans and other ethnic minority should not socially exclude themselves from
community activities like organ donation because when they do so it is to their
detriment because if you do not give, you will not receive and when you freely give,
you also freely receive.
• The bible says that for lack of knowledge our people perish, Africans must do
everything possible to acquire knowledge and good education because there is power
in knowledge and education.
• In order to prevent commercialization, transplantation law should be promulgated
effectively and purposeful programme to eliminating poverty is another step towards
decreasing the commercialization of human organs.
38

39. • Governments should control agencies and hospitals engaged in transplantation with
respect to their profit motives.
• International co-operation should be promoted in organ donation and transplantation.
Developed countries can help developing countries in promoting research in
transplantation technology. A global vision associated with a local vision can
facilitate the promotion of organ donation and transplantation.
• One of the efficient means to promote organ donation is to educate people about the
scarcity of human organs for transplantation and Africans should be in the forefront of
this campaign as presently they are the most disadvantaged.
Evangelium Vitae (no. 101) speaks about the proclamation and promotion of life: "The
Gospel of life is given to us as a good to be shared with all people including Africans: so that
all men and women may have fellowship with us and with the Trinity." Organ donation and
transplantation highlights the relational and social dimensions of human life. Through organ
donation and transplantation also one can proclaim and promote the gospel of life. More
clearly, patients in a critical stage of kidney or other organ failure have to either undergo
transplantation or face death. In these people one has to see the real face of the other.' We
have to promote basic ethical care for the other. We cannot force anyone to donate, but
people should be motivated to make free and voluntary donations. In this condition, a spirit of
charity, relevant both from religious and secular points of view can work properly with
regard to the promotion of organ
References
1, UK Obstetric Surveillance System (UKOSS), Dr Marian Knight from the National
Perinatal Epidemiology Unit at the University of Oxford
Centre for Maternal and Child Enquiries (CMACE) Perinatal Mortality 2008: United Kingdom.
CMACE: London,
http://health.howstuffworks.com/medicine/modern/face-transplant1.htm
P. Bruzzone: Religious Aspects of Organ Transplantation
Volume 40, Issue 4, Pages 1064-1067 (May 2008)
Cultural aspects of Organ transplant: Ann Acad Med Singapore. 1992 May; 21(3):421-7.
Scaria Kanniyakonil: The Promotion of Organ Donation and Transplantation
http://www.lifeissues.net/writers/kan/kan_03organdonation1.html#b25
NHS information leaflet on organ donation
39

40. 40

41. 41

42. FAITH and FACTS
Balancing Perspectives and Achieving Engagement
Sharon Platt-McDonald MSC, RHV, RM, RGN
Faith and Facts
42

43. Overview
It is stated that faith is the confident belief or trust in the truth or trustworthiness of a person,
idea, or thing. Faith impacts may aspects of an individual’s life. Studies demonstrate that
religious beliefs and practice amongst some cultural groups in the UK may preclude
individuals from making health choices that are deemed by medical professionals to be
advantageous to their health. Find out what their faith permits and how they feel about its
interpretation. This enables better engagement when seeking to progress work around raising
organ donation amongst BME groups.
This summary paper also identifies how Seventh-day Adventists as a faith group is working
to raise awareness about organ donation within their church community and externally.
Faith
• Faith is the confident belief or trust in the truth or trustworthiness of a person, idea, or
thing.
• Religious beliefs and practice amongst some cultural groups in the UK may preclude
individuals from making health choices that are deemed by medical professionals to
be advantageous to their health.
• Find out what their faith permits and how they feel about its interpretation.
Fact
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44. Some facts you may already know
• BME are 3-4 times more likely to be affected with kidney failure
• The organ donor taskforce states that 8% of the UK population are of BME origins
yet 25% of patients actively waiting for kidney transplants are from the BME
population
• BME’s wait anywhere between 2-8 years for kidney transplant
• BME’s are more likely to die waiting for transplants.
• Only 1.7% of donors are black, 1.6% Asian and 95.6% are white.
• Organ transplantation has brought about a revolution in the treatment of diseases such
as end-stage kidney, heart, and liver failure.
• Organs will have a better life expectancy coming from its own ethnic group (this is
what we call tissue typing).
The Gift of Life
• Organ transplantation has brought about a revolution in the treatment of diseases such
as end-stage kidney, heart, and liver failure.
• Organs will have a better life expectancy coming from its own ethnic group (this is
what we call tissue typing).
44

45. Information
Much stereotypical ideas and prejudices are due to lack of information. Here are a few
suggestions when raising awareness about organ donation.
• Find out what people know
• Find out what people don’t know - then inform them
• Use the published resources e.g. NHS UK Transplant which identifies specific faith
groups and their beliefs and practice around organ donation
• We need to share information on what faith groups believe in order to foster better
understanding of cultural norms
• We need to disseminate more widely information on the cultural risk factors for
kidney disease
Giving information without any connection does not always yield the best results.
Befriending and building trust are keys to encourage engagement. Here are some ideas I have
implemented in the past with positive outcomes.
Building Trust
“The people whose lives you touch may forget what you said, but they will never forget
how you made them feel.” — David B. Haight,
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46. • Inform the faith community of the importance of their involvement in shaping the
awareness of organ donation in their community and faith group
• Use specific faith / culturally targeted resources e.g. NHS UK Transplant leaflets
• Include reports / testimonials of organ recipients or donors from BME background
• Involve faith leaders in decision making so they feel included in the process
• Invite people of faith to join the debate so their views are represented
Befriending
• Become acquainted with the beliefs / views of diverse faith groups
• Attend their community events and show interest in their way of life
• Find out what is important to them
• Ask them what they feel would be helpful in reaching people from their faith or ethnic
background
• Involve individuals who they respect or leaders in their community to help champion
the message
Tackling Fear
Michael Prithard - “Fear is that little darkroom where negatives are developed”
46

47. • Much fear is based on ignorance
• Find out what people are afraid or unsure of
• Be informed – use data and published resources to answer their questions where
relevant
• Present information in places they frequently attend
• Invite them to awareness events to give them additional information
• The NHS UK Transplant leaflets which identifies specific faith groups and their
beliefs and practice around organ donation can provide a basis for discussion
Personalise the Message
It was Dennis Kimbro who said this: Success is knowing that one human being has
breathed a little easier because you lived
• Think of a relative, a neighbor, a church member, a work colleague whom you know
have severe hypertension, uncontrolled diabetes or already suffering from some
degree of renal failure.
• Find out the places they frequent and whether they would like you to assist them with
raising the awareness for donors in their community.
• Touch base with them, befriend them, try and understand the condition they are
facing, take time to listen to them, empathize and encourage.
• Find out from them what they feel would be helpful in raising awareness
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48. SDA Church Engagement
Here is an outline of how the Seventh-day Adventist church in the British Isles have been
working to raise awareness in this area
• 2007 – Sharon Platt-McDonald became a member of the Organ Taskforce working
group as a representative for the SDA church in the British Isles
• Reported all organ donation meetings I attended in National journals and church
magazines / publications to raise awareness that this was an important issue
• 2009 – One of our church members- Sonia Clarke Swaby received the prestigious
Mary Seacole Award for her work as a Transplant Coordinator and progressed work
to raise awareness on organ donation amongst ethnic minority groups
• On an annual basis I write to 300+ health ministry leaders and health professionals in
our churches across the British Isles to update on organ donation work
• I have involved our organisational presidents, executive officers / leaders and pastors
to participate in evaluation of faith related Organ Donation leaflets
• I was invited to make a presentation to the British Union Conference Executive
committee of 40 members to present on Organ Donation and the involvement of our
church annually
• 4 pastors representing our large majority ethnic minority churches (Luton, Leicester,
Leeds, Southall) were interviewed and included in focus groups to discuss their
beliefs around Gifting
48

49. • I have been engaged as a speaker at community events on raising awareness re Organ
Donation
• Following awareness events, I write up community events in national newspaper e.g.
The Voice re our church input in this key area
• In order to spread the message I have sought to engage the following groups and
departments within our church community: e.g. Health, Communications, Youth,
Education, Women Ministries, Men Ministries, Community Services, Pastoral and
Outreach Ministries
Hope
“Hope is the companion of power, and mother of success; for who so hopes strongly has
within him the gift of miracles” Samuel Smiles
Hope is also about celebrating the milestones along the way. This helps individuals realise
that progress is possible even though it may take time.
• In order to break barriers and touch lives we need to engender hope in others.
• Our goal is to increase the amount of donors.
• The gift of life gives people hope.
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50. Persistence
James Bryant Conant states: “Behold the turtle. He only makes progress when he sticks his
neck out
• Be persistent in sharing the message
• Find creative ways of raising awareness and keep asking what is relevant for the
groups you are trying to reach
• If one approach does not work, try another
• Keep informing faith groups of the message you are trying to put across
Breaking Barriers – Touching Lives
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51. Achieving Engagement
“Everyone is trying to accomplish something big, not realizing that life is made up of little
things” Frank A Clarke
• Find out what people want to know
• It’s easy to assume that people know where to find relevant information or have
knowledge about what is available.
• Make people feel that their contribution is important
• Identify barriers and address them
• Work with faith and community leaders so that this becomes their project which they
engage in, not something they observe from the sidelines
• Offer people choices – this opens up perspective and very often they make the better
choice.
• Keep the goal of achieving more donors as an end point but bring people along with
you on the journey to the destination.
Finally
• Be persistent in sharing the message
• Find creative ways of raising awareness and keep asking what is relevant for the
groups you are trying to reach
• If one approach does not work, try another
• Keep informing faith groups of the message you are trying to put across
“Everyone is trying to accomplish something big, not realizing that life is made up of little
things” Frank A Clarke. Success happen one step at a time. Therefore celebrating the
milestones along the way keeps the vision of our goals illuminated. Raising awareness for
organ donation is possible amongst all communities but more so amongst those of BME
groups. Let’s celebrate the journey so far.
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52. 52

53. Religious Perspectives on Organ Donation
Thomas Halley
53

54. What do the major religions say?
The six major world faiths in Britain (Buddhism, Christianity, Hinduism, Islam, Judaism and
Sikhism) are all supportive of organ donation. Details, including quotations from faith
leaders, are available from an NHS online leaflet:
http://www.organdonation.nhs.uk/ukt/newsroom/fact_sheets/religious_leaflets/general_religi
ous_leaflet_2009.pdf
Officially – no objection
Diversity
While this leaflet is based on accurate research, the overall picture of religious perspectives is
more complex. Firstly there are minority faiths that fall outside the parameters of the major
world faiths (e.g. Jainism, Baha’ism, Rastafarianism, Shintoism, Confucianism,
Zoroastrianism, and Jehovah’s Witnesses). Secondly, within the major religions themselves
there may be a diverse range of ways of interpreting sacred texts, leading to conflicting views
on a sensitive subject like organ donation. There may even be no single agreed religious
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55. authority to speak on such matters in a way that would fairly represent the adherents of a
particular faith group.
The following groups may have objections to organ donations on religious or cultural
grounds:
• (Judaism) – some isolated Orthodox rabbis
• (Islam) - some South Asian Muslim scholars
• Christian Science
• Jehovah’s Witnesses
• Shintoists
• Confucians
• Native Americans
• Roma
• African Americans
It will be noticed that some of these groups are ethnic or cultural groups rather than faith
groups. The first four on the list may be basing their objections on their particular
interpretations of sacred texts. As for the latter five groups, they may be coming from a
perspective of folk religion, where a desire for the body to remain intact at death may be
linked to a fear that the spirit from an incomplete body may not be able to find rest.
Respect for Conscience
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56. Whatever the reasons for a person having reservations about organ donation, in our
globalised world we must be prepared for situations where people who might benefit from
organ donations may initially have a problem reconciling these kinds of surgical procedures
with their conscience. We may be impatient with people who seem to be opposing the
progress of modern healthcare, but to override someone’s religious or cultural beliefs could
cause more problems than we realise. Pope John Paul II even went as far as to say, “Forcing
someone to violate his conscience ‘is the most painful blow inflicted to human dignity. In a
certain sense, it is worse than inflicting physical death, or killing.’”
Religious people can change...
Although people may have religious reasons for opposing organ donation, we do not need to
assume that people will hold these views unwaveringly throughout their lifetime. People can
change. When faced with a life-threatening illness in their own life or the life of a loved one,
a theoretical view can sometimes change and people can begin to consider receiving help
from medical technology that was once considered objectionable.
And it is not just people that change; organisations can change too. The Jehovah’s Witnesses
are a case in point. Over the years this religious group has earned a reputation for opposing
blood transfusion, and before 1980 they did not permit organ donation. However, the position
on organ donation has subsequently changed and their official website currently states:
The Witnesses do not feel that the Bible comments directly on organ transplants; hence,
decisions regarding cornea, kidney, or other tissue transplants must be made by the
individual Witness.
http://www.watchtower.org/e/hb/index.htm
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57. A study of Native American views on organ donation has also shown a change in viewpoints
over time.
There was some initial resistance to the idea of organ donation because traditional healers had
beliefs about the body having to remain intact in order to enter the spirit world. However, it
was found that most tribes had prayers and rituals that could be used to keep the spirit whole
in cases when the body was not intact at the time of death. In this way the benefits of modern
science could be embraced without abandoning ancient traditions.
Some people from African, Afro-Caribbean and African American backgrounds may have
reservations about donating organs from deceased patients, because of the custom of open
casket funerals. Yet this need not be a problem once it has been understood that organ
donation does not mutilate the body in a visible way that would make an open casket funeral
impossible. Once again, people are likely to change their views on this topic once the facts
have been clearly explained and fears have been allayed.
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58. Ethical objections
As we examine religious views on organ donation we could make a generalisation that
although some elements of folk religion can cause opposition to organ donation, there is more
support than opposition from the established faith groups. Where opposition does occur in the
major world faiths, it is more to do with related ethical issues, rather than organ donation in
itself.
For example, there are questions which revolve around the technical definition of the point of
death. Is a person dead when the heart stops beating or when brain function ceases? Where
people are unclear on this issue there may be concern about organs being harvested from
people before they are completely dead.
A second cause for concern arises in cases when money has changed hands, either as a direct
payment for an organ or as some sort of compensation. Pope John Paul II has strongly
objected to this practice:
“… any procedure which tends to commercialise human organs or to consider them as items
of exchange or trade must be considered morally unacceptable, because to use the body as
an object is to violate the dignity of the human person.”
Thirdly, there is the potential for exploitation of the poor and vulnerable. African Americans
have shown some resistance to organ donation which has been based on a long history of
exploitation and abuse at the hands of European Americans. This has given rise to fears that
white doctors might not do their utmost to keep black people alive, especially if a white
person is waiting for organs belonging to a black patient.
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59. Furthermore, there is the case of Kenichiro Hokamura, a Japanese man with a failing kidney.
Having grown impatient with waiting for a transplant in a country with cultural taboos
against organ donation, he went online and bought a kidney from a Chinese man who was on
death row. “I feel sorry for the executed man but he was going to die anyway, and now his
kidney is contributing to a life again.”
This cost the patient about £33,000, but even the most fervent supporter of capital
punishment might have concerns about the potential for the abuse of human rights if this
kind of transaction were to become commonplace.
http://search.japantimes.co.jp/cgi-bin/nn20100823a5.html
Conclusion
We have seen that while the official teachings of the larger world faiths support organ
donation, individuals form these faiths may have objections, whether for cultural reasons or
due to different interpretations of scripture. Beliefs which fall under the umbrella of folk
religion may be more likely to conflict with organ donation, but it is possible for people to
change when they are given the time and space to understand new technology and adapt
traditions and rituals. Where ethical dilemmas arise in connection with organ donation then
people of all faiths or none will look to legislators to protect the vulnerable from exploitation.
There may also be a need for medical and nursing colleges to ensure that trainee healthcare
professionals are aware of the links between the religious beliefs of patients and attitudes to
organ donation.
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60. 60

61. Organ Donor Recipient Testimony
Mr Kirit Modi
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62. EBEMRC
Essex Black & Ethnic Minority Research Centre
Invitation to attend
Organ Donation Awareness Workshop
The aim of the workshop is for experts to present clinical facts about
organ donation and transplant and for cultural and faith leaders to
discuss the social, cultural and religious perspectives to organ
donation and to see these as a way of saving more lives.
Place: Brentwood, Essex
Venue: Sawyers Church Hall, Sawyer Hall Lane
Brentwood, CM15 9BN
Date: 25 September 2010
Time: 12: 00 – 17:00 hours
Dinner will be served after the workshop
For more information or to reserve a place please contact
info@ebemrc.org.uk or call Dr Osaru Iguisi 07981990263
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63. EBEMRC
Essex Black & Ethnic Minority Resource/Research Centre (EBEMRC) is a registered charity
with the strategic mandate to promote business, education, employment, health, social and
cultural wellbeing of Black and Ethnic Minority (BEM) communities living in Essex, through
Research, Skills Development Training and Engagement Consultancy.
Statistics show that Black and Ethnic Minority community members experience low
patronage of healthcare services, low educational achievement, higher unemployment rates,
greater concentrations in routine and semi-routine work and lower earnings. Black and Ethnic
Minority members, even those enjoying relative success, have been found not to be doing as
well as they should be given their educational, professional and other characteristics. Among
the many barriers found to these are lack of engagement between BEM communities, policy-
makers and service providers, lack of services that are tailored to meet the needs of BEM
communities, discrimination by employers and service providers, no additional specialist
services but adopting the provision of mainstream services to meet the needs of these groups.
Addressing these issues requires engagement by a wide range of organisations in the public,
private and voluntary sectors.
In order to address the barriers and meet the needs of the BEM communities in Essex,
EBEMRC has created six divisions to build knowledge base in the areas of cultural diversity
and awareness training, business, education and employment mentoring, employability skills
training, healthcare services research and awareness creation, local partnerships and networks
in the public and voluntary sectors.
Current Event: BEM Organ Donation and Transplant Awareness Workshop
10,000 people in UK are in need of organ transplant to save or enhance their lives. Within the
BEM community, organ donation rates are relatively low among black African, Caribbean
and South Asian people and are 3 times more likely to need a kidney transplant than the
white population. Last year, more than 60 black African, Caribbean and Asian patients died
while waiting.
Chris Rudge of UK Transplant provided evidence that 23% of the people who are waiting for
an organ transplant are from black African, Caribbean and South Asian ethnic minority
groups and only 3% of organ donors come from that background. Professor Gurch Randhawa
of University of Bedfordshire, Institute for Health Research said that a transplant would be
successful only if the donor came from the same ethnic group as the recipient so that there
was a better chance of a close match of tissue type and blood group between the donor organ
and the recipient.
To effectively address the problem of low rate of organ donation among the Black African,
Caribbean and South Asian groups requires education and raising awareness of issues
pertaining to clinical, cultural and religious values among BEM and the mainstream
community. It is important to consider whether issues of cultural, economic and religious
value differences have influence on organ donation rate among the mainstream groups and
the different BEM communities.
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64. EBEMRC
Essex Black & Ethnic Minority Research Centre
Registered Charity Organisation
BEM BLOOD AND ORGAN DONATION AWARENESS WORKSHOP
Workshop Agenda (Brentwood, 25/09/2010)
Workshop MC: Dr Emmanuel Okoro and Barrister Mrs Ohakwe
Time Programme Activities
12.00 – 12:20 Arrival and registration
12:20 – 12:25 Welcome address by Dr Osaru Iguisi & Pastor Jordan
12:25 – 13:25 Blood and organ transplant presentations
(Michelle Tyler and Prof. Gurch Randhawa)
13:25 - 13:35 Cold buffet/Tea/coffee break
13:35 - 13:45 Testimony of Mrs Kala Mistry’s (organ recipient)
13:45 - 14:45 Clinical, cultural and religious perspectives
(Dr Ogbonmwan, Sharon Platt-Mcdonald, Thomas Halley)
14:45 – 14:55 Traditional African and Asian drummers
14:55 – 15:00 Testimony of Mr Kirit Modi (organ recipient)
15:00 – 16:20 Discussions, questions and answers session
16:20 – 16:30 Closing remarks
16:30 – 16:00 Photographs
17:00 Dinner
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65. Workshop Speakers
• Professor Gurch Randhawa, Director, Institute for Health Research, University
of Bedfordshire
• Sharon Platt-Mcdonald, Director, Health Ministries/Disability Awareness,
British Union Conference of Seventh-day Adventists
• Michelle Tyler, Team Manager, NHS Eastern Organ Donation Services
• Dr Stephen E.O. Ogbonmwan, Consultant Gynaecologist
• Thomas Halley, Sawyers Church, Brentwood
• Kala Mistry, Organ recipient
• Kirit Modi, Organ recipient
Masters of Ceremony
Dr Emmanuel Okoro, MD
Barrister Mrs Pat Ohakwe
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