Differences in Attitude towards Cadaveric Organ Donation: Observations in a Multiracial Malaysian Society

Background Willingness to donate organs is affected by socio‐cultural and religious values. The Malaysian society is made up of three ethnic groups: Malay, Chinese, and Indian, with Islam, Buddhism and Hinduism as their religions respectively. This study examined the knowledge and perception towards organ donation for each group. Methods This study was conducted at University Malaya Medical Centre, Kuala Lumpur, Malaysia. Relatives of patients awaiting treatment at the emergency department answered a questionnaire on knowledge and attitude on organ transplantation. Results A total of 904 questionnaires were completed; 90.6% would accept organs, 43.6% would donate, and 4.0% carried donor cards. The reasons for reluctance to donate included: fear of organs being used for research (18.8%), desire to be buried whole (18.0%), fear of less active treatment if patient is known to be a donor (12.8%). Malays were less willing to accept organs from a different race (63.5%) compared to Chinese (83.3%) and Indians (83.8%) (OR=0.35, 95%CI: 0.23‐0.54 and OR=0.34, 95%CI: 0.22‐0.51 respectively) and also less likely to donate organs (29.8%) as compared to Chinese (42.1%) and Indians (63.2%) (OR=0.57, 95%CI 0.40‐0.83 and OR=0.24, 95%CI 0.17‐0.35 respectively). Malays were less willing to donate organs to another race compared to Chinese or Indians (OR=0.48, 95%CI 0.33‐0.70 and OR=0.22, 95%CI 0.15‐0.31 respectively). Only 34.7% of Muslims are aware of fatwa supporting organ donation. Conclusions The awareness of organ donation was low. Clear differences exist among ethnic groups. Cultural‐religious attitudes and lack of trust in the medical systems were reasons for reluctance to donation. Identifying socio‐cultural barriers and reassuring donors regarding medical care are required.