Effects of Commemorations and Postdonation Services on Public Willingness to Donate Bodies in China

Influence of religio-cultural beliefs on whole-body donation: A quantitative analysis of a predominantly South African Pedi Community

BACKGROUND

Body donation is a predominant mode of body sourcing in many countries including South Africa; however, it continues to be limited among the different ethnic groups in the Black African population of South Africa which have been observed to be largely unwilling to provide consent to donate their bodies. Religious and cultural beliefs have been suggested to influence willingness to donate one's body to science, with most religions regarded as accepting of body donation globally. In contrast, cultural beliefs and practices in the African continent impede body donation. Therefore, it is crucial to understand the factors that influence willingness to participate in body donation among the various ethnic groups of the Black African population of South Africa, particularly the Pedi ethnic group.

PURPOSE

This study sought to investigate factors that determine the disposition to participate in body donation and the influence of religious and cultural beliefs on willingness to consent to donate one's body among a predominantly Pedi community of the Black African population of South Africa in the Limpopo province.

METHODS

In this cross-sectional study, 300 four-page questionnaires were distributed to conveniently sampled individuals from the GaMaphale (Pipa) village of the Limpopo province of South Africa. Descriptive statistics (frequency tables and Pearson's chi-square test for independence) followed by a stepwise backward regression were conducted to obtain key factors determining willingness to donate one's body, the influence of religious and cultural beliefs, and also the likelihood of willingness to participate in body donation in this community. A p-value of < 0.05 was considered statistically significant.

RESULTS

A total of 190 (63 %) responses were obtained. The level of awareness about body donation was 30 % (n= 57/190), and 41 % (n= 78/190) of respondents were willing to donate their bodies. Age (p = 0.001), educational level (p = 0.037), belief in a higher entity (p = 0.007), ancestral (p < 0.001), and religious (p < 0.001) beliefs allowing for body donation were statistically associated with willingness to donate one's body. The elderly respondents were less likely to agree to donate their bodies compared to younger adults. Respondents who understood that religion allowed them to self-donate were 50 times more likely to agree to donate their bodies than those who did not.

DISCUSSION AND CONCLUSION

Findings reflect that a high percentage of respondents were unaware of body donation while a considerable number of respondents were willing to donate their bodies to science based on their religious and cultural beliefs allowing them to do so. Potential body donors from this community will likely be younger and belong to religions that allow body donation. The need to increase awareness about body donation programs through awareness campaigns, especially among religious organizations that may allow for body donation, is warranted in this community. This work was supported by the National Research Foundation (TTK220214660416).

Unsuccessful bypass and trapping of a giant dolichoectatic thrombotic basilar trunk aneurysm. What went wrong?

Aneurysms of the basilar trunk represent an exceptional challenge to the neurosurgeon, due to high mortality and surgical morbidity. We present a 69-year-old man with a giant dolichoectatic thrombotic basilar trunk aneurysm (BTA), who underwent right orbitozygomatic craniotomy, posterior cerebral artery (PCA) to right middle cerebral artery (MCA) bypass and trapping of the BTA. Unfortunately, patient died after surgery due to multiple foci of intraparenchymal haemorrhage and thrombosis of a short segment proximal to aneurysm trapped and his body was donated to the hospital, giving us the unique opportunity to compare intraoperative details with anatomical dissection findings, according to our previously published cadaveric neurosurgical research. The great and unique opportunity of this reported case, to learn by watching and watching again what has been done during surgery, to observe small vessels and brainstem perforators and to look at stiches of the bypass, SVG and the position of the clips, permits to refine the theoretical and practical skills for the treatment of complex aneurysms such as that one reported.

Commemoration of body donors in a religiously diverse society: A tale of two Korean medical schools

Although a diversity of religions exists in South Korea, with Buddhism and Christianity (Protestantism and Catholicism) being the two main faiths, Korean beliefs are deeply rooted in Confucianism. Despite the notion that the Confucian norm of filial piety discourages body donation to medical science, there has been a mindset shift in favor of body donation, driven by a heightened awareness of the body bequest programs and the care and dignity accorded to the altruistic body donors, together with the institution of commemorative services to honor them. As spirituality and religion are known to be factors that influence body donation, how religious- and non-religious-based memorial services are held to honor the donors as exemplified by two Korean medical schools-from a public university with no religious affiliation and from a Protestant-based university-are described here. The key concept of expressing gratitude and respect for the donors and their family members has positively impacted body bequest programs in this multi-religious society. Commemorative services held to pay tribute to the altruistic body donors may play an important role in inspiring a humanistic spirit in students, regardless of religious or non-religious beliefs, as exemplified by the two Korean medical schools. The takeaway here is that the elevation of spirituality in memorial services effectively resonates with society, thereby demonstrating the impact of spiritual principles independent of religious influence.

The relationship between body donation and attitudes toward death and altruism in Changsha City in China

In recent years, China has been facing a shortage of cadavers for teaching medical students. A better comprehension of the attitudes and factors influencing the general public's opinion toward body donation would be invaluable for planning and implementing body donation programs. Although altruistic attitude and attitudes toward death have received considerable attention in recent years globally, they have been largely understudied in China. Herein, the potential relationship between attitudes toward altruism and death, and willingness toward whole-body donation in a sample of university students in Changsha City in China were analyzed. A multi-stage sampling method was adopted to recruit 478 Chinese college students from two universities: the Medical College of Hunan Normal University (n = 272) and the College of Civil engineering of Hunan University (n = 206). The study participants were assessed by a sociodemographic questionnaire, the Death Attitude Profile-Revised (DAP-R-C) questionnaire, and the altruism scale. Moreover, Chinese University students demonstrated moderate willingness to donate their bodies. The mean score of the willingness of study participants to donate their bodies was 3.138 ± 0.933 (5-point Likert scale). Acceptance toward death, gender, and type of university were positive factors, whereas fear of death negatively affected willingness toward body donation. Regression analysis showed that factors, including gender (β = 0.237), type of university (β = 0.193), natural acceptance (β = 0.177), and fear of death (β = -0.160) influenced willingness toward body donation. Overall, the present study provides hitherto undocumented evidence on factors influencing willingness toward body donation among Chinese university students, which can assist in designing public awareness programs for encouraging body donation.

The impact of enhancing publicity and commemoration of body donors at Zhengzhou University, China

As a fundamental subject of medical education, human anatomy plays a critical role in the development of medical science. However, because of multiple factors including cultural conservativism and limited social understanding, China is facing a particularly severe shortage of bodies donated for anatomy education. Zhengzhou University (ZZU) has continued to uphold whole-body dissection as the preferred method for medical students to learn anatomy. For this study, records of registered individuals (who have signed a body donation agreement) and donors (whose bodies have been received) from 2001 to 2020 were collected and analyzed. The aim of this study was to explore the factors influencing the body donation program (BDP) at ZZU, and then reinforce the social understanding for the BDP. The results showed a significant increase in the numbers of both registered individuals and donors since 2015, which is the year the publicity and commemoration in honor of donors were increased. There were no significant differences between the biological male and female sexes in the registered individuals, but the number of male donors (12.85 ± 10.86, per year) was significantly higher than that of female donors (4.75 ± 4.53, per year). The current donor profile at ZZU is male in his 60/70s, while the profile of registered individuals is male or female in their 60s. Strengthening the publicity and commemoration in honor of donors may contribute to the implementation of BDPs.

Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective

Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P < 0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P > 0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.

Assessing the perceptions of individuals with differing levels and backgrounds of education towards whole-body donation

INTRODUCTION

The value of learning anatomy through cadaveric dissection is widely acclaimed; however, the demand for cadavers exceeds supply. For the number of donors to increase, there needs to be a broader understanding of what influences an individual's perception towards whole-body donation. The hypotheses were that individuals with a biomedical background or with higher levels of education would respectively have a more positive perception towards whole-body donation than those with an arts background or less education. Dissection experience was predicted to affect an individual's perception of whole-body donation negatively.

METHODS

To assess perceptions of whole-body donation, an online questionnaire was created consisting of statements developed using Thurstone and Chave's method. After ethical approval, the survey was distributed to students, academics, businesses and charities. Responses were allocated a mean score based on agreed statements. The Mann-Whitney U test was used to assess significance.

RESULTS

Significant difference in scores of individuals with biomedical science education compared to those with an arts education (P = 0.028, U = 39). No significant difference in scores of individuals with and without dissection experience (P = 0.394, U = 654.5). A significant difference in scores of postgraduates compared to graduates (P = 0.036, U = 13.5).

CONCLUSION

Individuals with a biomedical science education reflected a significantly higher positive perception of whole-body donation in comparison to individuals with an arts background. Although postgraduates had a significantly higher positive perception of whole-body donation compared to graduates, there was no trend between level of education and score. Individuals with dissection experience didn't have a more negative perception of whole-body donation.

Demographic and motivational factors affecting the whole-body donation programme in Nanjing, China: a cross-sectional survey

OBJECTIVES

To investigate the demographics and motivations of whole-body donors in China, and help suggest a solution to the problem of low body donation numbers.

DESIGN

A cross-sectional study on body donors in China. Demographic analysis of the donating information of deceased donors and in-depth interviews of potential body donors.

SETTING

Eleven districts in Nanjing, China.

PARTICIPANTS

Deceased whole-body donors who had donated their bodies to the body donation receiving station of Nanjing Medical University between 1 July 2009 and 30 June 2019 (n=835), and living registered whole-body donors (n=68).

RESULTS

Among the whole-body donor population, the numbers of males, people older than 65 years and those working as teachers, government officials, medical staff and farmers were significantly higher than those of the general Nanjing population. Donors with an education level of college or above accounted for nearly half of the deceased donors, and considered donating their bodies earlier in their lives than others. Cancer and heart disease were the major causes of death among donors. Interviews of the 68 living donors revealed the following major motivations for the decision to donate: to support medical education; to reduce their children's funeral burden; no longer holding traditional Chinese views on life and death; influence by role models and annoyance at complex funeral ceremonies.

CONCLUSIONS

Older people, people with an education level of college or above, labourers, teachers, government officials and farmers are the major groups that donate their bodies. Although people's motivations for donation are complex, their desire to support medical education is the most prevalent motivation. By helping focus on target groups for promotional messaging and identifying their prime motivations, this study's findings can provide a reference for promoting body donation in China.