Effect of language and country of birth on the consent process and medical suitability of potential organ donors; a linked-data cohort study 2010-2015

Karen M J Waller; James A Hedley; Brenda M Rosales; Nicole L De La Mata; Imogen K Thomson; John Walker; Patrick J Kelly; Michael J O'Leary; Elena Cavazzoni; Kate R Wyburn; Angela C Webster

doi:10.1016/j.jcrc.2020.01.025

Effect of language and country of birth on the consent process and medical suitability of potential organ donors; a linked-data cohort study 2010-2015

J Crit Care. 2020 Jun:57:23-29. doi: 10.1016/j.jcrc.2020.01.025. Epub 2020 Jan 22.

Authors

Affiliations

¹ Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: [email protected].
² Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: [email protected].
³ Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: [email protected].
⁴ Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: [email protected].
⁵ Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: [email protected].
⁶ Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; School of Economics, Faculty of Arts and Social Sciences, University of Sydney, Sydney, Australia. Electronic address: [email protected].
⁷ Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: [email protected].
⁸ New South Wales Organ and Tissue Donation Service, Sydney, Australia. Electronic address: [email protected].
⁹ New South Wales Organ and Tissue Donation Service, Sydney, Australia. Electronic address: [email protected].
¹⁰ Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Renal Department, Royal Prince Alfred Hospital, Sydney, Australia. Electronic address: [email protected].
¹¹ Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia. Electronic address: [email protected].

PMID: 32014644
DOI: 10.1016/j.jcrc.2020.01.025

Abstract

Purpose: Australia has unmet need for transplantation. We sought to assess the impact of cultural and linguistic diversity (CALD) on family consent and medical suitability for organ donation.

Method: Cohort study of New South Wales donor referrals, 2010-2015. Logistic regression estimated effects of primary language other than English and birthplace outside Australia (odds ratios OR, with 95% confidence intervals, 95%CI). Outcomes were whether families were asked for consent to donation, provided consent for donation, and whether the referral was medically suitable for donation.

Results: Of 2977 organ donor referrals, a similar proportion of families had consent for donation was sought between non-English speakers and English speakers (p = .07), and between overseas-born compared to Australian-born referrals (p = .3). However, consent was less likely to be given for both non-English speakers than English speakers (OR 0.44, 95%CI:0.29-0.67), and those overseas-born than Australian-born (OR 0.54, 95%CI:0.41-0.72). For referrals both overseas-born and non-English speaking, families were both less likely to be asked for consent (OR 0.67; 95%CI:0.49-0.91) or give consent (OR 0.24; 95%CI0.16-0.37). There was no difference in medical suitability between English speakers and non-English speakers (p = .6), or between Australian-born and overseas-born referrals (p = .6).

Conclusion: Intervention to improve consent rates from CALD families may increase donation.

Keywords: Birthplace; Consent; Donation; Ethnic groups; Language; Tissue and organ procurement; Transplantation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Australia
Child
Child, Preschool
Cohort Studies
Cultural Characteristics*
Ethnicity*
Family
Female
Humans
Infant
Infant, Newborn
Informed Consent*
Language*
Logistic Models
Male
Middle Aged
Odds Ratio
Organ Transplantation
Semantic Web
Tissue Donors*
Tissue and Organ Procurement / methods*
Treatment Outcome
Young Adult