Organ Transplant Questionnaire

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Organ Transplant Questionnaire

Michael Holloway mhollowa at ccnova.sunysb.edu
Sat Jul 18 16:46:00 EST 1992
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If you are affiliated with a medical school, or are in some way
interested or involved with organ transplantation, I would greatly appreciate
it if you were to read over this questionnaire. We are going to distribute it
among the medical students here at SUNY Stony Brook this fall. If it could be
distributed at other medical schools as well it would greatly increase it's
applicability.
Since the numbers show that the main problem in obtaining organ donors
is the lack of sufficient concern in the medical community we decided to try
attacking the problem at the bud: in the medical school. We hope that this
survey will identify what the attitudes are among tommorrow's medical
professionals that might make it difficult for them to participate in
organ donation. Better than half of all potential donors are lost either
because brain death was not declared or because no one approached the next of
kin (despite the fact that hospitals are required by law to do so).
Any comments or help in distribution are greatly needed and
appreciated.
Organ donation and transplantation questionnaire
Directions: Please circle the best answer from the list
below each question.
Indicate your current year in medical school.
1

Indicate your age group.

less than 22
23-25
26-30
greater than 41

31-40

Indicate the annual income range of the household in which

you grew up.
less than 15,000
15-30,000
31-50,000
50-100,000
100,000-200,000
greater than 200,000
Indicate your sex.
M

Do you know a transplant recipient?

yes

no

Have you heard through the popular media about organ

donation/transplantation?
yes

no

If your answer is yes to the above question, how did you

hear of it?
radio
television
newspaper
other

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Organ Transplant Questionnaire

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http://www.bio.net/hypermail/bioforum/1992-July/000529.html

Have you known anyone waiting for a transplant?

yes

no

If the answer to the above question is yes, what organ was

involved?
kidney
liver
heart
other
Do you believe that organ transplantation is an effective
treatment?
never
sometimes
most of the time

often
all the time

Is liver transplantation an effective treatment?

never
sometimes
all the time

often

most of the time

Is kidney transplantation an effective treatment?

never
sometimes
all the time

often

most of the time

How do you feel about the possibility of your own organs

being used for transplants in the event of your death?
would
might
would
would

not want to donate

want to donate
want to donate
donate only under some other special circumstance

Have you signed an organ donor card (or driver's license

organ donation consent)?
yes
no
Would you consider signing an organ donor card?
yes
no
not sure
need more information
How likely is it that your family would allow your organs
to be used for transplants?
likely

possible

unlikely

never

To your knowledge how effective are the present efforts

toward obtaining donors?
very effective
effective most of the time
partially effective
not very effective
Are people who need an organ transplant likely to have a
donor found for them?
likely
unlikely

possible
never

How closely would the demand for organs match the supply
if all potential donors were properly identified and
consent for donation obtained?
demand
demand
demand
demand
demand

would
would
would
would
would

far exceed supply

exceed supply
be roughly the same as supply
be less than supply
be far less than supply

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Organ Transplant Questionnaire

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http://www.bio.net/hypermail/bioforum/1992-July/000529.html

How would you rank the importance of ethical issues in

considering the use of any medical technology?
very important
not important

important to some degree

How would you rank the importance of ethical issues in

considering the use of organ transplants?
very important
not important

important to some degree

Do you believe that there is a danger that donated organs

could be misused or misappropriated?
never
sometimes
most of the time

often
all the time

Should the cost of an organ transplant be used as a

criteria for prescribing it as a treatment?
never
sometimes
all the time

often

most of the time

If you were caring for a patient who was a potential

donor, would you discuss organ donation with the patient's
next of kin?
never
sometimes
most of the time

often
all the time

How important is the determination of brain death to

identifying a potential donor?
very important
important to some degree

not important

Do you know the criteria for brain death?

yes

no

Could there be any situation in which you yourself would

be reluctant to make a determination of brain death?
never
sometimes
all the time

often

most of the time

If you thought that a patient's next of kin did not

understand the concept of brain death to what degree would
this affect your willingness to discuss organ donation
with them?
greatly

to some degree

never

As a physician, would you see yourself as being

responsible for identifying potential organ donors?
never
sometimes
all the time

often

most of the time

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