Sociological aspects of Organ Transplantation

CEBU, Philippines - Very advance in social and medical technology has social and cultural implications. At the individual patient's level, the psychological consequences are as important," said Dr. Elizabeth Ventura, dean of the College of Social Sciences and Philosophy of UP Diliman.

In her paper entitled "Sociological aspects of organ transplantation" discussed during the "Proceedings of Symposium on Organ Donation", now published by the Department of Health, it was learned that "immediately, the religious issue comes to mind."

"In a multi-religion society like ours, there are specific religious groups which view organ transplant as taboo," she said.

"Religious beliefs about being whole even in death prevail among certain religious groups," she added. "In fact, in one religious group, even blood transfusion is prohibited."

"The use of animal parts can also be a religious issue. The moral dilemma would be violating religious beliefs or possible death, especially if the patient or donor belongs to another religion."

According to her, a positive factor existing in our culture is the close kinship ties and the general attitude of helping --- or altruism. In our culture, families will feel better if the organ donor comes from within the kinship system. It is easier all around for the family, the patient and the medical professionals.

Another cultural factor is the Filipino's view of the self. "It is one which is not only biological but involves the essence of the inner self, holistic," quoting from Virgilio Enriquez, the primary proponent of Filipino psychology. Counseling interventions for both the donee and the donor take this into consideration to facilitate the entire process before and after the organ transplantation.

Another part of the macro context is the socio-economic condition of the patient, the donor and their families. "The harvesting of organs for monetary consideration," Ventura said, "is an issue in itself."

"On the other hand, the patient needing a transplant but who cannot afford the procedure is another economic issue to contend with. Access to advances in medical technology may not be made available to everyone and raises the issue of medical justice. Can health insurance answer the problem?"

Further, Ventura said that a major factor is social support which can come in various forms, such as showing empathy by significant others, providing goods and services, providing information on the procedure itself. "It is a well-established fact that the presence of social support leads to a faster recovery regardless of one's illness," she also said.

"Organ transplantation can be seen as directly affecting personal and social identities similar to people's need for physiological homeostasis," Ventura further pointed out. "There is a need for a sense of social and psychological equilibrium. A major event such as an organ transplant temporarily upsets the characteristic pattern of behavior and lifestyle. As a response, the individual employs habitual problem-solving mechanism until a balance is restored."

She stressed that when the habitual responses are inadequate, this leads to heightened fear perhaps or guilt or other unpleasant feelings. "It is then important that the patient, the donee and their families are psychologically prepared for the event."

"I know for a fact that NKTI (National Kidney and Transplant Institute) does already a lot of counseling along this line. The potency of the experience is also related to the pervasive threat to the essence of the individual's life and adaptation," Ventura underscored.

"The loss of key roles and an uncertain future which may involve death have to be appraised. Hospitalization, convalescence and rehabilitation are part of the cognitive assessment that an individual may undergo. Patients may view their situation as a major discontinuity in their lives and report changes in their adaptation, self-concept and perception of the future."

On the other hand, most cope adequately with the aftermath of their operation. "Long-term survivors of serious ailment attain levels of psychological and social functions that are similar to "normal" people. In fact, some report enhanced personal growth and integration."

"If we view organ transplantation as a major event in life, we know that those who survive crisis actually experience personality growth," she pointed out.

"They manifest a greater concern for and a sense of community with others. A change in a focus of energy from the constant pressure of work to family relationships, more realism and acceptance of life, and heightened awareness of religious and humanitarian values." (FREEMAN)