By Mike Holloway, PhD

C.L.A.S.S. Notes, Winter 1996-97 -- The public attitude toward organ donation is still the single most important determinant of whether someone will be given a chance at receiving a transplant. While local and national organizations do a great deal of fantastic work in speaking to people in schools and meetings, the large Partnership for Organ Donation Gallup poll (1) shows that the majority of the public gets their information about donation and transplantation from TV and movies; a statistic that should startle no one. The poll also shows that while a majority believe that organ donation is a decent idea, less than half are prepared to sign an organ donor card and discuss their wishes with family members. A stigma continues to exist about the subject of organ donation, and some members of minority groups speak openly of their deep distrust of organ procurement and allocation. (2)

The number of television shows using transplantation in some aspect of a plot device has exploded in the last several years. Few TV shows or movies portray transplantation in a positive manner and even fewer bother to give an accurate portrayal of the process of procurement and surgery. If they mention the donation shortage at all, it is only to make a "black market" and murder for the sake of obtaining organs seem plausible. All kinds of drama, adventure, and soap opera shows, some of which specialize in plausible, current events story lines, are basing their plots on the worst myths and urban legends that have been spread around the world in the last two decades. Two of the most notable examples include an episode of Law and Order in which a kidney is stolen from a kidnap victim (a repeat of this episode was recently broadcast on the Arts & Entertainment Channel immediately following a documentary on transplantation), and the November 11, 1996, episode of Chicago Hope, which portrays with relish the impossible scenario of a single resident misdiagnosing brain death. The patient recovers on the operating table as procurement begins. The surgeons then consider euthanizing the patient so that they can continue to take his organs. Strange Luck, The X-Files, ER, Voyager, at least four different soap operas, Picket Fences, Forever Knight, and many others have all portrayed organ procurement and allocation as horrible, criminal, and corrupt. This is aside from the various tabloid semi-documentary programs that will snatch up rumors or urban legends of organ theft and report them as proven fact. But that is an entire topic by itself. (3)

At least two major movies are currently being produced which feature murder and corruption in organ procurement. Actress Meg Ryan will be starring in "Heartless," and Director Steven Spielberg is making the movie "Spares," which is also due out soon as a novel.

Aside from the confusion these programs have introduced about the facts of transplantation, they have undoubtedly left an impression that organ donation is potentially harmful, and patients who need organs are not people most would find sympathetic. While it may be fiction, even viewers who can totally discount implausible story lines seen on the screen can’t help but come away with a negative impression after a constant barrage of these stories. More, and worse, are undoubtedly on the way.

I’m writing this article in the hopes of alerting people who might not be fully aware of this problem and to make a call for action. At least two media contact people of organizations involved in procurement and allocation have stated in the TRNSPLNT e-mail forum (4) that they cannot appear at any time to be scolding the writers, producers, or reporters who call them for help with their stories. They do not even try to inform them of the harm that negative and fallacious stories will have on the public’s appreciation for the need of organ donation. Organizations, professionals, and all concerned individuals need to make their concerns known to the media. When a television show or movie that is harmful to donation is released, or goes into production, it cannot be assumed that it is of no consequence. Many more people will have seen the recent Chicago Hope episode than will have seen even one of the costly Ad Council PSA spots.

Public awareness of various "life or death" health concerns is often crucial, but none more so than the need for organ donation. A constant barrage of negative and fallacious stories on other public health concerns would be intolerable, and quickly protested. I encourage everyone to bring up these issues in organizations they have contact with and encourage vocal protest. There will be people who do not understand the problem and will need some time to figure it out. The media themselves will insist that because it is just fiction they can portray anything they wish. This is, of course, obviously not the case. The need for responsibility in broadcast media is something that they, and the public, are constantly being reminded of in regards to many other issues. Organ donor education deserves to be at the top of the list of subjects viewed as essential and sensitive.

Dr. Holloway is co-owner and principal operator of the Internet e-mail list "TRNSPLNT."

1. The American Public's Attitudes Toward Organ Donation and Transplantation. The Partnership for Organ Donation. This document is available at TransWeb.

2. Arnason WB., Thomas Jefferson Memorial Church, Unitarian Universalist, Charlottesville, Va. Directed donation. The relevance of race. Hastings Center Report. 21(6):13-9, 1991 Nov.-Dec.

Plawecki HM., Plawecki JA., Improving organ donation rates in the black community. Journal of Holistic Nursing. 10(1):34-46, 1992 Mar.

Mozes, Hayes, Tang, Impediments to Successful Organ Procurement in the "Required Request" Era: An Urban Center Experience. Transplantation Proceedings 1991 October; 23(5):2545.

3. Articles and references dealing with organ theft urban legends are detailed in the bit.listserv.transplant FAQ.

4. Information about TRNSPLNT and an automatic subscription form can be found at http://home.columbus.rr.com/mhollowa/