fieldwork: october 2009 - european...
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Special Eurobarometer 333a “Organ donation and transplantation”
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European Commission
Special Eurobarometer 333a
Spe
cial
Eur
obar
omet
er 3
33a
/ Wav
e 72
.3 –
TN
S O
pini
on &
Soc
ial
This survey was requested by the Directorate-General Health and Consumers and coordinated by the Directorate-General for Communication (“Research and Speechwriting” Unit). This document does not represent the point of view of the European Commission. The interpretations and opinions contained in it are solely those of the authors.
Fieldwork: October 2009
Publication: June 2010
Organ donation and transplantation
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Special Eurobarometer 333a “Organ donation and transplantation”
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Eurobarometer 72.3
Organ donation and transplantation
Conducted by TNS Opinion & Social at the request of Directorate General Health and Consumers
Survey co-ordinated by Directorate General Communication
TNS Opinion & Social Avenue Herrmann Debroux, 40
1160 Brussels Belgium
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Special Eurobarometer 333a “Organ donation and transplantation”
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Table of contents
INTRODUCTION...............................................................................................4
1. FAMILY DISCUSSIONS ............................................................................7
2. REGULATION OF ORGAN DONATION AND TRANSPLANTATION..............11
3. DONATING ONE’S OWN ORGANS...........................................................15
4. DONATING AN ORGAN FROM A DECEASED CLOSE FAMILY MEMBER ......21
5. REASONS FOR NOT DONATING ORGANS ...............................................26
CONCLUSIONS...............................................................................................29
ANNEX TECHNICAL SPECIFICATIONS QUESTIONNAIRE TABLES
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Special Eurobarometer 333a “Organ donation and transplantation”
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INTRODUCTION
The therapeutic use of human substances, including the transplantation of organs, is
an integral part of modern health systems and vital to the management of serious
health conditions throughout Europe.
Organ transplantation has been used successfully to treat serious health conditions
since 1954. Because of the success of this treatment, demand for organs continues to
exceed the number of donors, at an accelerating rate. In this context of accelerating
demand, it is important that efforts to increase the number of organ donors are
accompanied by high quality and safety standards. Improvement in the efficiency and
accessibility of transplantation systems is also key.
In 2008 the European Commission adopted a proposal for a Directive on standards of
quality and safety of human organs intended for transplantation1. At the same time,
the Commission launched an Action Plan2 designed to the promote the availability of
deceased and living donors across the European Union, increase the supply of organs,
enhance transplantation systems and ensure the quality and safety of procedures. The
Action Plan includes a number of priorities including the improvement of knowledge
and communication regarding organ donation and transplantation issues, both among
health professionals and the general public. The following Eurobarometer findings
highlight current attitudes in this area.
This Eurobarometer survey includes questions on behaviours and attitudes in relation
to organ donation and transplantation. It is based on a Eurobarometer survey of
26,788 European citizens carried out in October 2009 in the 27 European Union
Member States, as well as 3,504 interviews in the candidate countries (Croatia, Turkey
and the Former Yugoslav Republic of Macedonia) and the Turkish Cypriot Community3.
The latest research on organ donation and transplantation was preceded by two
previous Eurobarometer on this subject, the first in 2002 within the then 15 European
1 Proposal for a Directive of the European Parliament and of the Council on standards of quality and safety of human organs intended for transplantation (December 2008) 2 Commission of the European Communities Action Plan on Organ Donation and Transplantation (2009-2015): Strengthened Cooperation Between Member States. 3 Further information on the methodology used can be found in the technical note which specifies the interview methods as well as the intervals of confidence.
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Special Eurobarometer 333a “Organ donation and transplantation”
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Union Member States4, and the second in 2006 within the enlarged Union of 25
Member States5.
****
This Eurobarometer survey was commissioned by the European Commission's
Directorate General SANCO. It was carried out by the TNS Opinion & Social network
between 2 October and 19 October 2009. The methodology used is that of Special
Eurobarometer surveys as carried out by Directorate General for Communication
(“Research and Speechwriting” Unit)6. A technical note on the methodology for
interviews conducted by the institutes within the TNS Opinion & Social network is
annexed to this report. This note indicates the interview methods and the confidence
intervals7.
The Eurobarometer web site can be consulted at the following address:
http://ec.europa.eu/public_opinion/index_en.htm
We would like to take the opportunity to thank all the respondents across the continent
who have given their time to take part in this survey.
Without their active participation, this study would not have been possible.
4 October-December 2002. http://ec.europa.eu/public_opinion/archives/ebs/ebs_183.5_fr.pdf 5 Interviews for the 2006 Eurobarometer on Organ Donation and Transplantation were conducted between 6 October and 8 November 2006 among 28,584 people in the 25 Member States, 2 accession states and the Turkish Cypriot Community. http://ec.europa.eu/public_opinion/archives/ebs/ebs_272d_en.pdf 6 http://ec.europa.eu/public_opinion/index_en.htm 7 The results tables are included in the annex. It should be noted that the total of the percentages in the tables of this report may exceed 100% when the respondent can give several answers to the same question.
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Special Eurobarometer 333a “Organ donation and transplantation”
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In this report, the countries are represented by their official abbreviations. The
abbreviations used in this report correspond to:
*Cyprus as a whole is one of the 27 European Union Member States. However, the “acquis communautaire” is suspended in the part of the country that is not controlled by the government of the Republic of Cyprus. For practical reasons, only the interviews conducted in the part of the country controlled by the government of the Republic of Cyprus are recorded in the category “CY” and included in the EU27 average. The interviews conducted in the part of the country not controlled by the government of the Republic of Cyprus are recorded in the category “CY(tcc)” [tcc: Turkish Cypriot Community]. ** Provisional code which does not prejudge in any way the definitive nomenclature for this country, which will be agreed following the conclusion of negotiations currently taking place at the United Nations.
ABBREVIATIONS EU27 European Union – 27 Member States DK/NA Don’t know / No answer BE Belgium BG Bulgaria CZ Czech Republic DK Denmark D-E East Germany DE Germany D-W West Germany EE Estonia EL Greece ES Spain FR France IE Ireland IT Italy CY Republic of Cyprus*
CY (tcc) Area not controlled by the government of the Republic of Cyprus
LT Lithuania LV Latvia LU Luxembourg HU Hungary MT Malta NL The Netherlands AT Austria PL Poland PT Portugal RO Romania SI Slovenia SK Slovakia FI Finland SE Sweden UK The United Kingdom HR Croatia TR Turkey MK** The Former Yugoslav Republic of Macedonia
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1. FAMILY DISCUSSIONS
- Four out of ten Europeans have already discussed the issue of organ
donations and transplantations with their family -
Some 40% of Europeans have raised the issue of organ donation and transplantation
with their family, compared to 59% who have never broached this subject8. This
percentage is very similar to that recorded in 2006, when 41% of European Union
citizens (at that time composed of 25 countries) had discussed the issue with their
family.
EB58.2Oct.-Dec. 2002
EU15 EU25 EU15 NMS10 EU27 EU15 NMS12
Yes 46% 41% 44% 25% 40% 44% 27%
No 52% 58% 55% 73% 59% 56% 72%
Don't know 2% 1% 1% 2% 1% 0% 1%
EB66.2Oct.-Nov. 2006
QE1 Have you ever discussed human organ donation or transplantation with your family? - %
EB72.3October 2009
Despite the fact that levels of discussion of this topic in 2009 are consistent with those
reported in 2006, an analysis by country reveals a continued disparity between
results for the oldest EU Member States and the most recent ones, with the latter
generally recording lower scores for this question.
As seen in 2006, in the October 2009 wave there are significant differences in levels
recorded among countries that joined the European Union before 2004: Dutch
respondents continue to report the highest levels of discussion (74%), followed by
those in Sweden (62%), while interviewees in Portugal report low levels of discussion
(25%), as do those in Greece (32%). Notable in 2009 is the fact that the proportion of
respondents in the United Kingdom and in Finland who report discussing this topic with
their family has dropped respectively from 43% to 37% and 47% to 41%. By contrast
there have been significant increases in levels of discussion in Italy (45% up from 39%
in 2006) and Austria (37% up from 24% in 2006).
Of the countries that joined the European Union after 2004, Malta continues to stand
out as the only new Member State to record a score for organ donation family
8 QE1 Have you ever discussed human organ donation or transplantation with your family?
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discussions in line with the European average (40%). All other recent Member States
record levels below the European average. There were, however, notable increases in
discussion levels in Slovenia (35% in 2009, up from 30% in 2006), and the Republic of
Cyprus (33% in 2009 up from 19% in 2006). The lowest (and declining) levels of
discussion are recorded among respondents in Latvia, Estonia and the Czech Republic
(15%, 17% and 18% respectively).
Results for this question in the three candidate states, Croatia, Turkey and the Former
Yugoslav Republic of Macedonia, are all in the lower range (25%, 21% and 19%
respectively), as are those in the Turkish Cypriot Community (19%).
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A socio-demographic analysis also reveals significant differences:
Starting with gender: 44% of women said that they had discussed this subject
with their family compared to 36% of men.
Age is also a criterion that creates important differences: people aged between
25 and 54 are the most likely to discuss this topic with their family (43% of 25-
39 year olds and 45% of 40-54 year olds), while those aged 15-24 are the least
likely to broach the subject (33%). Interestingly, the oldest age group, those
aged 55 and over, remain less likely than average to discuss this topic with
their family (37%).
Occupational and educational skews are quite striking: discussion of the topic
increases significantly with education level (53% of those who have studied up
to or beyond the age of 20 compared to 32% of those who left school at age 15
or earlier) and is more prevalent among people in managerial jobs (59%) than
among unemployed people (31%), the retired (35%), students (36%) or
manual workers (39%).
A more in-depth analysis of age by education reveals that the lower levels of
discussion among the older age groups and retired people is to a degree related
to their overall lower education levels. Europeans over the age of 55 are more
likely to have left school at age 15 or earlier compared to the European average
for this level of education.
Similarly, it is no coincidence that both people in managerial positions and
those with higher education levels are more likely than average to discuss
organ donation with their families, as the two factors are intertwined.
Europeans in managerial positions are more likely to have higher education.
The key discriminator for this question is, thus, education.
Finally, financial hardship and social positioning are factors which influence
discussion levels. Respondents who have difficulty paying bills most of the time
are significantly less likely to discuss organ donation with their families,
compared to those who hardly ever experience this difficulty (31% compared to
43%), and people who rank themselves lower on the social hierarchy are less
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likely to broach this subject than those who give themselves a high ranking
(33% compared to 46%).
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2. REGULATION OF ORGAN DONATION AND
TRANSPLANTATION
- Just under three in ten Europeans know the regulations in their country for
the donation and transplantation of human organs -
Some 28% of Europeans are aware of laws governing the donation and transplantation
of organs in their country, it appears from a new question added in 20099. By contrast,
68% of people surveyed said they did not know such laws, and 4% could not answer
this question.
EU27 EU15 NMS12
Yes 28% 30% 21%
No 68% 67% 73%
Don't know 4% 3% 6%
EB72.3October 2009
QE2 The donation and transplantation of human organs is regulated by (NATIONALITY) law. Do you know the regulations in (OUR COUNTRY) for the donation and transplantation of human organs? - %
A geographical analysis of results reveals significant differences by country, with a
general pattern of higher awareness levels in the oldest European Union Member
States and lower levels in the most recent ones.
The highest awareness level of laws relating to organ donation is noted in the
Netherlands (64%) followed by Denmark (45%). Most other countries which joined the
European Union before 2004 record awareness levels in the 20% to 40% range, the
exceptions being Greece and Austria, where levels are considerably lower (14% and
19% respectively).
The lowest awareness levels are noted in the Czech Republic and Estonia (10% and
8% respectively), followed by Latvia and Bulgaria (both 15%). Slovakia and Romania
also report awareness levels in the lower range (16% and 18% respectively).
9 QE2 The donation and transplantation of human organs is regulated by (NATIONALITY) law. Do you know the regulations in (OUR COUNTRY) for the donation and transplantation of human organs?
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While two of the three candidate states, Turkey and the Former Yugoslav Republic of
Macedonia report awareness levels in the lower range (both 18%) the other candidate
state, Croatia, falls within the average European range (32%). The awareness level of
the Turkish Cypriot Community is quite low (15%).
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A socio-demographic analysis of awareness of laws governing organ donation and
transplantation in Europe reveals the following:
No significant differences by gender and only minimal ones by age: a slightly
higher than average percentage of 40-54 year olds (33%) reported awareness
of such laws.
Education is a key differentiator in terms of response to this question, with 40%
of Europeans educated to 20 years of age or later recording knowledge of organ
donation laws in their country. By contrast, only 21% of respondents who left
school at age 15 or earlier are aware of such laws.
Occupation also plays a role here: 41% of people in managerial positions are
aware of the laws, compared to only 26% of the retired or those taking care of
the home, 25% of manual workers, 24% of students and 19% of unemployed
people.
As noted in section 1.2 of this report, in relation to family discussion of organ
donation, education as a factor is correlated with results by age and occupation:
in this case education drives higher levels of awareness of organ donation laws
among people in managerial jobs and those under 55 years of age.
Also noted in section 1.2 was the observation that respondents experiencing
financial hardship and those who rank themselves lower on the social hierarchy
are less likely to discuss organ donation with their family. These groups are also
less likely to be aware of laws on this subject in their country. Only 20% of
people who report having difficulty paying their bills most of the time (and the
same percentage of people ranking themselves lower on the social ladder)
report awareness of organ donation laws. By contrast, 30% of people who
hardly ever experience financial hardship, and 35% of people who position
themselves higher on the social ladder, report awareness of such laws.
There is a strong association between family discussion and knowledge of laws. Of
those who have discussed organ donation and transplantation with their family, nearly
half (48%) say they know the laws governing this area in their country.
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3. DONATING ONE’S OWN ORGANS
- The majority of Europeans are willing to donate one of their own organs
after their death -
Some 55% of Europeans are willing to donate one of their organs to an organ donation
service immediately after their death10. This proportion is in line with that recorded in
2006 (56%). Just over one in four is against the idea (27%), while almost one in five
felt unable to express an opinion on the topic (18%). In line with the results of the
question on family discussions, the lower than average levels of willingness noted in
new Member States is compensated by stable to increasing levels of willingness in
most other parts of Europe.
EB58.2Oct.-Dec. 2002
EU15 EU25 EU15 NMS10 EU27 EU15 NMS12
Yes 59% 56% 57% 50% 55% 57% 46%
No 22% 26% 25% 31% 27% 26% 31%
Don't know 19% 18% 18% 19% 18% 17% 23%
EB66.2Oct.-Nov. 2006
EB72.3October 2009
QE3 Would you be willing to donate one of your organs to an organ donation service immediately after your death? - %
An analysis of results by country reveals some significant differences. Continuing the
pattern observed in 2006, respondents in Northern European countries show a higher
willingness to donate their own organs. The strongest support is noted once again in
Sweden (83%), while high levels are recorded in Finland and Belgium (both 72%) and
Denmark (70%). The exception to this geographical skew is, once again, Malta where
support for organ donation is unusually high and 77% of people are willing to donate
their own organs. There has been a slight drop in support for organ donation in the
Netherlands in this latest Eurobarometer (64% compared to 69% in 2006).
At the other end of the scale, those most reluctant to donate their own organs tend to
reside in Eastern European countries, especially Latvia where the majority of people
(52%) say ‘no’ to this question, and Romania (31% saying ‘yes’ compared with 40%
saying ‘no’). In the Czech Republic, opinion is quite divided, 45% of respondents
10 QE3 Would you be willing to donate one of your organs to an organ donation service immediately after your death?
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saying ‘yes’ and 37% saying ‘no’). Bulgaria also records one of the lowest levels of
support for organ donation (42% for and 27% against).
In Greece and Austria, interviewees are also divided on this matter (43% saying ‘yes’
and 38% ‘no’ in Greece and 39% saying ‘yes’ and 41% ‘no’ in Austria). It should be
noted that the support levels for organ donation have dropped by 10 points in Greece
(53% in 2006).
Of the candidate countries, Croatia reports average levels of support (53%) while
scores in Turkey and the Former Yugoslav Republic of Macedonia are in the lower
range (32% and 26% respectively).
The most notable increases in willingness to donate one’s own organs from 2006 to
2009 are recorded in Italy, Spain and Romania (4 points), the Republic of Cyprus and
Austria (6 points).
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An in-depth socio-demographic analysis does not reveal any significant differences
according to either the gender or age of interviewees. As noted in 2006, only people
aged 55 and over stand out: the percentage of this group willing to donate one of their
own organs after death is lower than the European average (49% compared to the
55% EU27 average).
Significant relationships are, however, noted between willingness to donate one’s own
organs, education level and occupation.
In line with 2006 results, people educated to age 20 or later are significantly
more likely to support organ donation (65%) than people who have left school
at age 15 or earlier (45%). Once again, just over one third of people who left
school at age 15 or earlier (35%) say they are unwilling to donate one of their
own organs after death, compared to only 18% of those educated to age 20 or
later.
Those in managerial jobs are more likely to show willingness to donate one of
their own organs than those looking after the home or unemployed people
(68% compared to 50% and 49% respectively).
As was the case with family discussion and awareness of laws about organ donation, a
more in-depth analysis of age by education and occupation levels reveals that the
lesser willingness to donate one’s own organs among the older age groups and retired
people is to a degree related to their education level, as is the greater willingness
among people in managerial jobs.
Also as noted previously, financial hardship and self-described social position are key
discriminators when it comes to attitudes relating to organ donation. Those who report
having difficulty paying bills most of the time are significantly less likely to consent to
donate one of their own organs after death than are respondents who hardly ever
experience this difficulty (48% compared to 58%). Similarly, respondents who rank
themselves lower on the social ladder are significantly less likely to consent than those
who give themselves a higher social ranking (49% compared to 59%).
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- The fact that respondents have already discussed this subject with
their family has a strong influence on their willingness to donate one of
their own organs –
As noted in 2006, discussion of the issue of organ donation and transplantation with
one’s family has a strong association with willingness to donate one’s own organs after
death. Of those who have discussed the topic with their family, 76% are willing to
donate their own organs. Discussion is clearly a stronger differentiator in this area than
socio-demographic factors (education aside).
Further, people’s understanding of the laws governing organ donation is noted in 2009
as another key differentiator of support for organ donation. Of those who are aware of
the laws governing organ donation in Europe, a large percentage (77%) say they are
willing to donate their own organs after death.
Therefore, following a trend observed in 2006, the latest results are encouraging as
they point to the possibility of increasing the levels of support for organ donation in the
European Union via communication campaigns which encourage more open discussion
of the topic and better understanding of laws surrounding it. These activities should be
focused on, but not limited to, recent European Union Member States that record low
levels of both family discussion and education.
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Special Eurobarometer 333a “Organ donation and transplantation”
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4. DONATING AN ORGAN FROM A DECEASED CLOSE FAMILY
MEMBER
- The majority of Europeans are not only willing to donate one of their
own organs after their death, they would also agree to donate an organ
from a deceased close family member –
Over half of Europeans (53%) would agree to donate an organ from a deceased close
family member if asked in a hospital11.
From 2002 to 2006 a significant evolution in European opinion on this particular
question was noted: the proportion of people who said they would give their consent
increased by 8 points (from 46% to 54%) over that period. In 2009, the higher level of
consent has been maintained, with only 1 point difference in the ‘yes’ responses. ‘Don’t
know’ responses have also been maintained (22% in 2009 compared to 23% in 2006).
A similar result is noted in 2009, compared to 2006, in regard to the ‘no’ answers for
the two organ donation questions (consent to donate one’s own organs after death and
consent to donate an organ from a deceased close family member). While the
percentage of people willing to donate their own organs is slightly higher than the
percentage of those willing to donate organs from a deceased close family member
(55% versus 53%), the opposite is true for refusals. The percentage of those who
would refuse consent for donation of their own organs is once again slightly higher
than the percentage of those who would refuse consent for donation of an organ from
a deceased close family member (27% versus 25%).
Finally, in regard to the difficulty of making a decision on donating one’s own organs or
those of a deceased close family member, the results are similar to those seen in
2006. Once again, the proportion of ‘don’t know’ responses for the former is lower than
the latter (18% versus 22%), suggesting less confusion about making this decision for
oneself than on behalf of others.
11 QE4 If you were asked in a hospital to donate an organ from a deceased close family member, would you agree?
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Special Eurobarometer 333a “Organ donation and transplantation”
- 22 -
Not surprisingly, the countries with the highest levels of consent for donation of the
organs of a deceased close family member continue to be, in 2009, the same countries
where high levels of consent for donation of one’s own organ are noted.
Sweden (73%) and Finland (72%) remain the top two pre-2004 EU countries in terms
of consent levels, recording scores very similar to those seen in 2006 (74% and 73%
respectively). Of note in 2009 is the fact that the Netherlands has dropped from third
place in consent levels (62% down from 66% in 2006), a pattern similar to that seen
in section 1.4 regarding willingness to donate one’s own organs. Malta continues to
stand out as the recent European Union Member State with an unusually high level of
consent (72%).
Among the countries that joined the European Union before 2004, two countries stand
out as having support levels for family organ donation below the European average:
Austria which has the second lowest level of acceptance at 35% (consistent with the
2006 results), and Greece where acceptance levels dropped significantly from 54% in
2006 to 41% in 2009. These two countries aside, the lowest levels of acceptance are
noted in one of the new Member States, Romania (34%), Latvia (36%) and the Czech
Republic (41%). The three candidate countries, Croatia, Turkey and the Former
Yugoslav Republic of Macedonia all report lower than average levels of consent for
donation of the organs of deceased close family members (45%, 36% and 32%
respectively).
The most notable increases in ‘Yes’ responses to this question from 2006 to 2009 are
seen in Italy and in Bulgaria (3 points) and Lithuania (5 points).
As noted in 2006, the results in Germany are interesting: while German respondents
have levels of family discussion in line with the European average (44%) and higher
than countries that joined the European Union before 2004 such as Portugal (25%),
Greece (32%), Belgium (36%), the UK and Austria (both 37%), Spain (40%), or
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Special Eurobarometer 333a “Organ donation and transplantation”
- 23 -
Finland (41%), the support for organ donation in Germany (both one’s own organs and
those of deceased close family members) is considerably lower than average. While
family discussions of the topic in Germany show healthy levels, it is interesting that
knowledge of laws governing organ donation and transplantation are lower than
average in this country. In summary, it appears that encouraging open discussion of
this topic alone will not necessarily increase support levels in Germany, and that
broader changes in attitudes and increased knowledge of legal issues are required for
positive evolution in this score.
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Special Eurobarometer 333a “Organ donation and transplantation”
- 24 -
A socio-demographic analysis of responses shows that, in line with response to
other questions in this report, education is the strongest socio-demographic
discriminator of willingness to donate organs from deceased close family members.
Some 64% of people who studied to age 20 or later are willing to donate the organs of
deceased close family members, compared to 45% of people who left school age 15 or
younger. Following on from this (as education and occupation are intertwined as
factors), 67% of people in managerial jobs give a positive response to this question,
compared to 50% of people looking after the home, 49% of unemployed people and
48% of the retired. Unemployed people have the highest level of refusal to give
consent (30%), and people looking after the home show the highest level of indecision
(26% don’t know).
Just as people who have discussed the topic with their family tend to have higher
levels of consent for donation of their own organs, they also have higher levels of
consent for donation of the organs of deceased close family members (71% compared
to 41% of those who have not had such discussions). Similarly, knowledge and
understanding of laws governing organ donation and transplantation play a role in
raising levels of consent to donate the organs of others just as it does in relation to
one’s own organs: 73% of those who were aware of laws in their country on this topic
also showed willingness to donate the organs of close family members after their
death, compared to only 46% of those not aware of such laws).
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Special Eurobarometer 333a “Organ donation and transplantation”
- 25 -
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Special Eurobarometer 333a “Organ donation and transplantation”
- 26 -
5. REASONS FOR NOT DONATING ORGANS
- Distrust of the system and fear of manipulation of the human body are the
dominant reasons for not donating one’s own organs or those of a deceased
close family member -
Almost a third of Europeans (31%) who are unwilling to donate either their own organs
or those of a deceased close family member are unable to give a reason for their
reluctance12. Of the remainder, a quarter (25%) are fearful of manipulation of the
human body, and one in five (21%) cite distrust of the system (either the
transplantation system, consent system, and/or general social system) as a barrier to
donation. Less than one in ten Europeans (7%) do not support organ donation for
religious reasons.
12 QE5 If you would be unwilling to donate your own organs or those of a close family member what would these reasons be?
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Special Eurobarometer 333a “Organ donation and transplantation”
- 27 -
When we consider barriers to organ donation on a country level, significant differences
are apparent, not necessarily related to region of European Union or number of years
as a Member State.
One of the candidate countries, Turkey, stands out as the place where respondents are
most likely to be reluctant to donate organs for religious reasons (29%). Other
countries where respondents are more likely to be reluctant to donate organs for
religious reasons (compared to the European average) are Romania (17%), Austria
(15%), the Former Yugoslav Republic of Macedonia (12%), and Slovakia (11%).
Distrust of the system, on the other hand, is more prevalent as a barrier in Greece
(45%), the Czech Republic (33%), Slovakia (31%) and Italy (30%).
People in the Czech Republic are also more likely to cite fear of manipulation of the
human body as a barrier to donation (45%), as are the citizens of Poland (36%),
Latvia (35%), Slovakia and the Republic of Cyprus (both 33%).
Confusion about reasons for not donating organs is most prevalent in Malta: of the
relatively low proportion of people who do not support organ donation in that country,
the majority (76%) say they don’t know why. A similarly high proportion of ‘don’t
know’ answers is noted in Ireland (64%), Finland (53%), Estonia (52%), and the two
newest Member States, Bulgaria and Romania (both 48%).
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Special Eurobarometer 333a “Organ donation and transplantation”
- 28 -
There were no significant socio-demographic differences in reasons for withholding
consent to organ donation.
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Special Eurobarometer 333a “Organ donation and transplantation”
- 29 -
CONCLUSIONS
While the majority of European citizens support organ donation, with 55% expressing
their willingness to donate their own organs after death and 53% willing to consent to
donate organs of deceased close family members, the level of support has not
increased at a EU level in the latest Eurobarometer, which is a matter of concern since
the demand for donors is rapidly accelerating.
Support levels for organ donation are generally higher in the countries that joined the
European Union prior to 2004 than they are in the Member States that joined after
2004 (with the notable exception of Malta). The exceptions to this pattern are
observed in Greece and Austria which have low levels of support. It should be noted,
however, that there has been an increase in the level of family discussion and
willingness to donate one’s own organs in Austria between 2006 and 2009; an
encouraging trend. Improvements have also been observed in Italy on all levels (family
discussions, willingness to donate one’s own organs after death, and willingness to
consent to donate the organs of deceased family members).
As noted in this report, and the preceding Eurobarometer, discussion of this topic with
one’s family is positively correlated with support for organ donation. It is not
surprising, then, that as discussion levels have "plateaued" between 2006 and 2009,
so has willingness to consent to donate one’s own organs.
Aside from family discussions, education level is also noted as a key factor influencing
support for organ donation. Further, this factor is intertwined with a number of others,
including the fact that certain age groups (those aged 55 and over) and regions of
Europe (some of the more recent European Union Member States in particular), which
have had more limited access to higher education, tend to exhibit lower levels of
discussion, awareness and support generally for organ donation.
Finally, financial hardship appears to be a barrier to support for organ donation. Those
who have difficulty paying their bills are less likely to talk about this subject or to give
their consent to donation of their own organs or those of a deceased close family
member.
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ANNEXES
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TECHNICAL SPECIFICATIONS
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SPECIAL EUROBAROMETER N°333a “Organ donation and transplantation”
TECHNICAL SPECIFICATIONS
Between the 2nd and the 19th of October 2009, TNS Opinion & Social, a consortium created between TNS plc and TNS opinion, carried out wave 72.3 of the EUROBAROMETER, on request of the EUROPEAN COMMISSION, Directorate-General for Communication, “Research and Speechwriting”. The SPECIAL EUROBAROMETER N°333a is part of wave 72.3 and covers the population of the respective nationalities of the European Union Member States, resident in each of the Member States and aged 15 years and over. The EUROBAROMETER 72.3 has also been conducted in the three candidate countries (Croatia, Turkey and the Former Yugoslav Republic of Macedonia) and in the Turkish Cypriot Community. In these countries, the survey covers the national population of citizens and the population of citizens of all the European Union Member States that are residents in these countries and have a sufficient command of the national languages to answer the questionnaire. The basic sample design applied in all states is a multi-stage, random (probability) one. In each country, a number of sampling points was drawn with probability proportional to population size (for a total coverage of the country) and to population density. In order to do so, the sampling points were drawn systematically from each of the "administrative regional units", after stratification by individual unit and type of area. They thus represent the whole territory of the countries surveyed according to the EUROSTAT NUTS II (or equivalent) and according to the distribution of the resident population of the respective nationalities in terms of metropolitan, urban and rural areas. In each of the selected sampling points, a starting address was drawn, at random. Further addresses (every Nth address) were selected by standard "random route" procedures, from the initial address. In each household, the respondent was drawn, at random (following the "closest birthday rule"). All interviews were conducted face-to-face in people's homes and in the appropriate national language. As far as the data capture is concerned, CAPI (Computer Assisted Personal Interview) was used in those countries where this technique was available.
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COUNTRIES INSTITUTES N°
INTERVIEWS FIELDWORK
DATES POPULATION
15+ ABBREVIATIONS
BE Belgium TNS Dimarso 1.001 02/10/2009 18/10/2009 8.866.411 BG Bulgaria TNS BBSS 1.000 02/10/2009 12/10/2009 6.584.957 CZ Czech Rep. TNS Aisa 1.066 02/10/2009 15/10/2009 8.987.535 DK Denmark TNS Gallup DK 1.040 02/10/2009 18/10/2009 4.503.365 DE Germany TNS Infratest 1.550 02/10/2009 18/10/2009 64.545.601 EE Estonia Emor 1.011 02/10/2009 18/10/2009 916.000 IE Ireland TNS MRBI 1.008 02/10/2009 18/10/2009 3.375.399 EL Greece TNS ICAP 1.000 03/10/2009 19/10/2009 8.693.566 ES Spain TNS Demoscopia 1.003 02/10/2009 18/10/2009 39.059.211 FR France TNS Sofres 1.000 02/10/2009 18/10/2009 47.620.942 IT Italy TNS Infratest 1.032 02/10/2009 17/10/2009 51.252.247 CY Rep. of Cyprus Synovate 503 02/10/2009 17/10/2009 651.400
CY(tcc) Turkish Cypriot Comm. KADEM 500 02/10/2009 16/10/2009 143.226 LV Latvia TNS Latvia 1.018 03/10/2009 18/10/2009 1.448.719 LT Lithuania TNS Gallup Lithuania 1.026 02/10/2009 16/10/2009 2.849.359 LU Luxembourg TNS ILReS 513 05/10/2009 16/10/2009 404.907 HU Hungary TNS Hungary 1.044 02/10/2009 18/10/2009 8.320.614 MT Malta MISCO 500 02/10/2009 17/10/2009 335.476 NL Netherlands TNS NIPO 1.007 02/10/2009 18/10/2009 13.288.200 AT Austria Österreichisches Gallup-Institut 1.005 02/10/2009 16/10/2009 6.973.277 PL Poland TNS OBOP 1.000 03/10/2009 19/10/2009 32.306.436 PT Portugal TNS EUROTESTE 1.031 02/10/2009 18/10/2009 8.080.915 RO Romania TNS CSOP 1.010 02/10/2009 15/10/2009 18.246.731 SI Slovenia RM PLUS 1.031 02/10/2009 19/10/2009 1.748.308 SK Slovakia TNS AISA SK 1.006 02/10/2009 18/10/2009 4.549.954 FI Finland TNS Gallup Oy 1.017 02/10/2009 19/10/2009 4.412.321 SE Sweden TNS GALLUP 1.012 02/10/2009 19/10/2009 7.723.931 UK United Kingdom TNS UK 1.354 02/10/2009 18/10/2009 51.081.866 HR Croatia Puls 1.000 02/10/2009 18/10/2009 3.749.400 TR Turkey TNS PIAR 1.004 02/10/2009 18/10/2009 52.728.513 MK Former Yugoslav Rep. of Macedonia TNS Brima 1.000 02/10/2009 12/10/2009 1.678.404
TOTAL 30.292 02/10/2009 19/10/2009 465.127.191
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For each country a comparison between the sample and the universe was carried out. The Universe description was derived from Eurostat population data or from national statistics offices. For all countries surveyed, a national weighting procedure, using marginal and intercellular weighting, was carried out based on this Universe description. In all countries, gender, age, region and size of locality were introduced in the iteration procedure. For international weighting (i.e. EU averages), TNS Opinion & Social applies the official population figures as provided by EUROSTAT or national statistic offices. The total population figures for input in this post-weighting procedure are listed above. Readers are reminded that survey results are estimations, the accuracy of which, everything being equal, rests upon the sample size and upon the observed percentage. With samples of about 1,000 interviews, the real percentages vary within the following confidence limits:
Observed percentages 10% or 90% 20% or 80% 30% or 70% 40% or 60% 50%
Confidence limits ± 1.9 points ± 2.5 points ± 2.7 points ± 3.0 points ± 3.1 points
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QUESTIONNAIRE
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QE1 QE1
1 12 23 3
QE2 QE2
1 12 23 3
QE3 QE3
1 12 23 3
Oui Non NSP
EB66.2 QB36
NOUVEAU
Seriez-vous prêt(e) à donner un de vos organes à un service de don d’organes tout de suite après votre mort ?
OuiNonNSP
NSP
EB66.2 QB35
Le don et la transplantation d’organes humains est régit par la loi (NATIONALITE). Connaissez-vous les lois en (NOTRE PAYS) pour le don et la transplantation d’organes ?
Avez-vous déjà discuté du don ou de la transplantation d’organes humains avec votre famille ?
OuiNon
Parlons maintenant d'un autre sujet.
POSER QE EN UE27 + CY(tcc) + HR + MK + TR
Yes No DK
EB66.2 QB36
NEW
Would you be willing to donate one of your organs to an organ donation service immediately after your death?
YesNoDK
DK
EB66.2 QB35
The donation and transplantation of human organs is regulated by (NATIONALITY) law. Do you know the regulations in (OUR COUNTRY) for the donation and transplantation of human organs?
Have you ever discussed human organ donation or transplantation with your family?
YesNo
Now let's talk about another topic.
ASK QE TO EU27 + CY(tcc) + HR + MK + TR
QuestionnaireEB723 37/54 22/09/2009
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QE4 QE4
1 12 23 3
QE5 QE5
1 1
2 23 34 45 5
QE6 QE6
1 12 23 3
NonNSP
EB58.2 Q59
POSER QE6 ET QE7 UNIQUEMENT EN UE27 - LES AUTRES ALLER AUX DEMOGRAPHIQUES
Avez-vous déjà donné votre sang ?
Oui
La peur de la manipulation du corps humainAutres (SPONTANE)NSP
NOUVEAU
Si vous n’étiez pas disposé(e) à donner vos organes ou ceux d’un membre de votre famille proche, quelles en seraient les raisons ?
(LIRE – UNE SEULE REPONSE)
Des raisons religieusesDe la méfiance envers le système (cela peut inclure le système de transplantation, le système de consentement ou en général le système de la société)
NonNSP
EB66.2 QB37
A l’hôpital, si on vous le demandait, donneriez-vous votre accord pour le don d’un organe d’un parent proche décédé ?
Oui
NoDK
EB58.2 Q59
ASK QE6 AND QE7 ONLY IN EU27 - OTHERS GO TO DEMOGRAPHICS
Have you given blood before?
Yes
Scare of manipulation of the human bodyOthers (SPONTANEOUS)DK
NEW
If you would be unwilling to donate your organs or those of a close family member what would these reasons be?
(READ OUT – ONE ANSWER ONLY)
Religious reasonsDistrust in the system (this could include the transplantation system, consent system or in general the society system)
NoDK
EB66.2 QB37
If you were asked in a hospital to donate an organ from a deceased close family member, would you agree?
Yes
QuestionnaireEB723 38/54 22/09/2009
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TABLES
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Special Eurobarometer 333a – Organ donation and transplantation
1ère colonne: EB72 automne 2009EU27 UE27
EU25 UE25
2ème colonne: % changement par rapport à EB66 automne 2006
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
Oui 40 -1 36 -2 22 0 18 -1 58 0 44 0 44 +2 44 +11 17 -3 40 0 32 -4 40 -5Non 59 +1 64 +2 76 -1 82 +2 42 +1 56 +1 56 -1 56 -10 83 +4 59 0 68 +4 60 +8NSP 1 0 0 0 2 +1 0 -1 0 -1 0 -1 0 -1 0 -1 0 -1 1 0 0 0 0 -3
1st column: EB72 autumn 20092nd column: % change from EB66 autumn 2006 EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2Yes 49 +2 45 +6 33 +14 19 -3 15 -10 31 +2 46 +4 29 +4 40 -2 74 -1 37 +13 32 +6No 51 -2 54 -3 67 -13 79 +3 84 +9 68 -2 53 -4 71 -4 60 +2 26 +1 63 -12 67 -5DK 0 0 1 -3 0 -1 2 0 1 +1 1 0 1 0 0 0 0 0 0 0 0 -1 1 -1
Erste Spalte: EB72 Herbst 2009 TR MKZweite Spalte: % Veränderungen im Vergleich zu EB66 Herbst 2006
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB72.3
Ja 25 -3 22 +6 35 +5 29 -1 41 -6 62 -4 37 -6 25 -5 21 19Nein 74 +3 76 -6 64 -6 71 +2 59 +6 38 +4 62 +5 74 +5 78 81WN 1 0 2 0 1 +1 0 -1 0 0 0 0 1 +1 1 0 1 0
QE1 Avez-vous déjà discuté du don ou de la transplantation d’organes humains avec votre famille ?QE1 Have you ever discussed human organ donation or transplantation with your family?QE1 Haben Sie mit Ihrer Familie schon einmal über Organspende oder Organtransplantation gesprochen?
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Special Eurobarometer 333a – Organ donation and transplantation
UE27EU27
BE BG CZ DK D-W DE D-E EE IE EL ES
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
Oui 28 33 15 10 45 27 28 30 8 25 14 21Non 68 67 80 88 53 69 69 68 91 70 85 76NSP 4 0 5 2 2 4 3 2 1 5 1 3
FR IT CYCY
(tcc)LV LT LU HU MT NL AT
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
Yes 33 36 27 15 15 36 20 23 29 64 19No 66 57 69 71 83 61 78 76 69 34 77DK 1 7 4 14 2 3 2 1 2 2 4
PL PT RO SI SK FI SE UK HR TR MKEB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3Ja 27 22 18 33 16 29 33 23 32 18 18Nein 65 74 73 66 82 70 65 74 66 79 78WN 8 4 9 1 2 1 2 3 2 3 4
QE2 Le don et la transplantation d’organes humains est régi par la loi (NATIONALITE). Connaissez-vous les lois en (NOTRE PAYS) pour le don et la transplantation d’organes ? QE2 The donation and transplantation of human organs is regulated by (NATIONALITY) law. Do you know the regulations in (OUR COUNTRY) for the donation and transplantation of human organs? QE2 Organspenden und -transplantationen werden durch das (NATIONALITÄT) Recht geregelt. Kennen Sie die rechtlichen Bestimmungen für die Spende und Transplantation von Organen in (UNSERE LAND)?
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Special Eurobarometer 333a – Organ donation and transplantation
1ère colonne: EB72 automne 2009EU27 UE27
EU25 UE25
2ème colonne: % changement par rapport à EB66 automne 2006
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
Oui 55 -1 72 +1 42 +2 45 +1 70 +1 45 -2 47 +1 51 +4 55 -3 64 -3 43 -10 61 +4Non 27 +1 22 -1 27 -4 37 -2 13 -5 32 +2 31 0 28 -4 30 +7 13 -3 38 +1 21 +5NSP 18 0 6 0 31 +2 18 +1 17 +4 23 0 22 -1 21 0 15 -4 23 +6 19 +9 18 -9
1st column: EB72 autumn 20092nd column: % change from EB66 autumn 2006 EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2Yes 66 -1 49 +4 63 +6 51 -1 25 -4 50 +2 62 0 53 +2 77 +2 64 -5 39 +6 53 +2No 20 0 29 -1 21 +5 23 -5 52 -7 27 -1 17 -8 29 -4 8 -2 23 +4 41 -6 25 -2DK 14 +1 22 -3 16 -11 26 +6 23 +11 23 -1 21 +8 18 +2 15 0 13 +1 20 0 22 0
Erste Spalte: EB72 Herbst 2009 TR MKZweite Spalte: % Veränderungen im Vergleich zu EB66 Herbst 2006
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB72.3
Ja 60 -6 31 +4 62 -1 48 -2 72 -1 83 +2 61 -2 53 -2 32 26Nein 20 0 40 -6 19 -3 35 0 18 0 9 +1 26 +1 28 +2 53 53WN 20 +6 29 +2 19 +4 17 +2 10 +1 8 -3 13 +1 19 0 15 21
QE3 Seriez-vous prêt(e) à donner un de vos organes à un service de don d’organes tout de suite après votre mort ? QE3 Would you be willing to donate one of your organs to an organ donation service immediately after your death? QE3 Wären Sie bereit, sofort nach Ihrem Tod eines Ihrer Organe einer Vermittlungsstelle für Spenderorgane zur Verfügung zu stellen?
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Special Eurobarometer 333a – Organ donation and transplantation
1ère colonne: EB72 automne 2009EU27 UE27
EU25 UE25
2ème colonne: % changement par rapport à EB66 automne 2006
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
Oui 53 -1 67 +2 44 +3 41 +1 61 -2 45 -2 46 0 48 +2 51 -2 58 +1 41 -13 59 0Non 25 +2 26 -2 22 -5 37 +1 19 -2 32 +5 31 +3 29 +1 30 +9 12 -4 34 +1 19 +9NSP 22 -1 7 0 34 +2 22 -2 20 +4 23 -3 23 -3 23 -3 19 -7 30 +3 25 +12 22 -9
1st column: EB72 autumn 20092nd column: % change from EB66 autumn 2006 EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2EB
72.3EB
66.2Yes 61 0 42 +3 55 +2 52 -6 36 -2 53 +5 58 -4 49 0 72 +1 62 -4 35 0 57 -1No 22 -1 27 -2 22 +6 18 -3 37 -6 22 -2 19 -7 27 -5 7 -3 24 +4 39 -4 18 -3DK 17 +1 31 -1 23 -8 30 +9 27 +8 25 -3 23 +11 24 +5 21 +2 14 0 26 +4 25 +4
Erste Spalte: EB72 Herbst 2009 TR MKZweite Spalte: % Veränderungen im Vergleich zu EB66 Herbst 2006
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB66.2
EB72.3
EB72.3
Ja 57 -6 34 +2 56 -3 47 +1 72 -1 73 -1 64 +1 45 -8 36 32Nein 19 -3 35 -2 20 -1 31 -3 16 -1 12 +3 20 +2 30 +5 46 47WN 24 +9 31 0 24 +4 22 +2 12 +2 15 -2 16 -3 25 +3 18 21
QE4 A l’hôpital, si on vous le demandait, donneriez-vous votre accord pour le don d’un organe d’un parent proche décédé ? QE4 If you were asked in a hospital to donate an organ from a deceased close family member, would you agree? QE4 Wenn Sie im Krankenhaus gefragt würden, würden Sie Ihre Zustimmung zur Organentnahme bei einem verstorbenen Angehörigen geben?
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Special Eurobarometer 333a – Organ donation and transplantation
UE27EU27
BE BG CZ DK D-W DE D-E EE IE EL ES
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
Des raisons religieuses 7 7 4 6 3 8 7 5 7 3 10 6De la méfiance envers le système (cela peut inclure le système de transplantation, le système de consentement ou en général le système de la société) 21 20 26 33 7 25 26 28 14 10 45 15La peur de la manipulation du corps humain 25 29 19 45 8 19 19 20 22 11 31 25Autres (SPONTANE) 16 21 3 5 45 20 20 19 5 12 6 22NSP 31 23 48 11 37 28 28 28 52 64 8 32
FR IT CYCY
(tcc)LV LT LU HU MT NL AT
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
EB72.3
Religious reasons 6 10 9 7 7 9 5 8 1 5 15Distrust in the system (this could include the transplantation system, consent system or in general the society system) 16 30 18 43 26 17 10 24 3 17 24Scare of manipulation of the human body 27 29 33 14 35 27 27 26 16 24 32Other (SPONTANEOUS) 19 7 7 0 8 24 44 9 4 30 13DK 32 24 33 36 24 23 14 33 76 24 16
PL PT RO SI SK FI SE UK HR TR MKEB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3EB
72.3Religiöse Gründe 6 9 17 3 11 1 5 4 5 29 12Misstrauen in das System (z.B. Misstrauen in Transplantationen an sich, in das System der Zustimmung zur Organspende oder generelles Misstrauen in das Gesellschaftssystem) 18 28 15 21 31 6 13 12 18 15 16Angst vor der Manipulation des menschlichen Körpers 36 20 11 16 33 8 17 25 27 27 33Sonstiges (SPONTAN) 11 6 9 43 9 32 29 22 10 6 5WN 29 37 48 17 16 53 36 37 40 23 34
QE5 Si vous n’étiez pas disposé(e) à donner vos organes ou ceux d’un membre de votre famille proche, quelles en seraient les raisons ? QE5 If you would be unwilling to donate your organs or those of a close family member what would these reasons be? QE5 Falls Sie nicht bereit wären, Ihre Organe oder die naher Angehöriger zu spenden, was wäre der Grund dafür?