Consumer Behavior Project

Cadaver Organ Donation

Praveen Jha
PGP/13/292
Contents
What is Cadaver Organ Donation?.................................................................................. 3
Transplantation of human organs act, 1994 .................................................................... 3
Problems with cadaver organ donation ........................................................................... 4
Organ donation awareness ............................................................................................. 4
Existing Support groups .................................................................................................. 5
Required change in attitude ............................................................................................ 5
Cognitive ...................................................................................................................... 6
Affective ....................................................................................................................... 6
Conative ...................................................................................................................... 6
FCB Grid ......................................................................................................................... 6
Attitude Commitment ....................................................................................................... 7
Targeting of Groups ........................................................................................................ 7
The Campaign: Life after Death ...................................................................................... 8
Objectives .................................................................................................................... 8
Execution ..................................................................................................................... 8
Storyboard for TV campaign ........................................................................................ 8
Concept of a Short Film: Vardhman ................................................................................ 9
References .................................................................................................................... 11
What is Cadaver Organ Donation?
Cadaver Organ Donation is a term given to the donation of organs after the death of an
individual. As per medical statistics, there are about 40 different people who can benefit
from one single body. Organ donation takes healthy organs and tissues from one person for
transplantation into another.
The organs that can be donated include:
Internal organs: kidneys, heart, liver, pancreas, intestines, lungs
Bone and bone marrow
Skin
Cornea

Human-to-human organ-transplant has been accepted worldwide by surgeons as the best

and often the only one line of treatment for a wide range of fatal diseases such as final
stage Renal Disease (kidney failure). Organ transplantation is regarded as one of the
greatest advances of modern science and surgery, which has given lease of life to many
people. A person can donate organs, after natural death or after 'brain death'. Only a few
tissues (like cornea, bone, skin and blood vessels) can be donated after natural death.
Whereas after brain death almost 37 different organs and tissues, including critical organs
like kidneys, heart, liver and lungs can be donated.

Human organ donation is fast developing into a major treatment protocol. However it is yet
to make any significant dent in India. A country with a population of over 1 billion people,
India lags behind in the implementation of a cadaveric donation programme. Annually, while
over 100,000 Indians suffer from End Stage Renal Disease, only a mere 3,000 are recipients
of a donor kidney, of which only a small percentage are cadaver organs. In fact, the total
number of patients who have received cadaver kidneys in India from 1995 to 2003 is only
524, an abysmally small figure. The major problem now facing transplant surgery is a
critical shortage of available organs.

Transplantation of human organs act, 1994

An Act was passed by the Government in 1994 to streamline various organ donations and
transplant activities in the country. The aims of this act were to:
 Regulate removal, storage, and transplantation of human organs for therapeutic
purposes.
 Prevent commercial dealings in organs.
 Accept brain death and make it possible to use these patients as potential organs
donors.
The Human Organ Transplantation Act has legalized the concept of brain death for the first
time in India. Since the passing of the legislation in India, it has become possible to
undertake organ transplants from brain dead donors. Furthermore, relatives need to be
educated about the futility of keeping brain dead accident victims 'alive'. A good motivator
is needed to encourage people to donate organs.
Problems with cadaver organ donation
Legal Problem
o The law in present form has certain pitfalls in form of identification of organ
trading cases from organ donation and penalization associated with former

Hospital problem
o Efforts and resources to identify & maintain brain dead donor are very high.
Also they may find themselves in legal nets if even a small bit of related
information is overlooked

Community problem
o Majority still isn’t aware of brain-death concept. It has been widespread
observation that relatives refuse to accept that as death and wait for miracle
to happen. More importantly often it is considered disrespect to the dead
body

Government problem
o Organ Transplant is still a very expensive medical procedure and a majority of
the transplant seekers are unable to get surgery in absence of funding or
subsidy from government/NGOs

Organ donation awareness

The successful implementation of organ donation is pivoted on the related awareness of the
masses and having more trained transplant coordinators. There is a need of proactive
attitude towards cadaveric donation of organs, adequate medical infrastructure, efficient
matching and distribution process of organs, coordination amongst hospitals and most
important of them all counseling of relatives for organ donation in case of a brain-death
The Indian society, mired by superstition and dogmatic beliefs, is not very acquiescent to
the idea of cadaver organ transplants. Most of them want no damage to the dead bodies
before they are cremated. They simply fail to understand that in a country with a long
waiting list for transplants, by consigning a body to flames, which could have actually given
lives to few, they are missing out on chance of helping somebody really needy out there.

The government can’t make it compulsory to donate organs of brain dead patients because
of the ethical issues involved. If they could, the issue of shortage of organs could have been
solved. One brain dead patient can help up to seven patients in critical stages to lead
normal lives. With the advent of newest form of organ preserve technologies, cardio-
thoracic surgeons suggest that the heart of a cadaver can be kept alive for five hours and
can even be flown from one city to another if needs be and transplanted.
Others measures -

 Communicating and educating people about concept of brain death and cadaver
organ donation at a young age, ideally at school/college level. That is the time when
they are more willing to accept new thoughts and shun dogmatic beliefs. Hospitals
could use their enlarge panel of doctors for this purpose.
 Tax exemption for documentaries/films on organ donation can be provided, as they
address a very important issue related to public welfare and concern. Government
should also support organization who try to assimilate funds and help to further
organ transplants for people who can’t afford it economically
 NGOs and government can bring the Donor families to front and honor them for their
noble endeavors. The people who got benefited should also be called on such
occasions, as people tend to get inspired more from the impact a certain activity
causes
 Other form of indirect initiatives can be provided to donor families, by hospitals and
governments. That apart from appreciating them will also serve as incentive for
many other whose relatives or they themselves could probably end as organ donors,
saving many lives in this process

Existing Support groups

There are already existing organizations helping out needy people by networking hospitals
in their own location and thus have made some tangible impact-

FORTE - Bangalore
MOHAN and TANKER - Chennai and Tamil Nadu
NKF, ZTCC and Narmada, MOHAN - Mumbai
ORBO, HOPE, DONATE (Delhi Organ Procurement Network and Transplant Education) - Delhi
MOHAN - Hyderabad

As visible from above, and very well representative of the society, the idea of cadaver organ
donation has founded relatively more support in south India than the north

Required change in attitude

The attitude change that we seek to bring about is difficult but not impossible. If we try to
put the perspective into a structured manner, there are three parts that form and then
support individual attitudes and based on these three touch points through which an
attitude change can be brought about
Cognitive
This refers to the knowledge and perceptions that are acquired by a combination of direct
experience with the attitude object and related information from various sources. This would
include educating school children, broadcasting direct interactions with donor families and
beneficiaries and films/documentaries dealing with such sensitive issue.

Affective
Post cognitive phase, one of the most important contributors to the attitude formation is the
positive impact the cognitive measures bring about in an individual, in terms of her/his
emotions or feelings about the noble cause of organ donation. Many times if mode of
communication is boring, either there is limited effect on the psyche of the people or the
effect is short lived and they forget about it in some time. The need is therefore of multi
channel campaign which reinforce any small positive attitudinal change, if it occurs

Conative
Once done with cognition and its affect, the likelihood that an individual will behave in
desirable way viz. pledging her/his organs or open to concept of organ donation if one of the
relatives is declared brain dead. Statistics show that in about 90% of cases where deceased
was a donor, relatives drop out in the last moment. For that counseling of relatives in the
case of brain death or a terminally ill patient could be helpful and effective

FCB Grid
If we put things in perspective using FCB grid, we can incite action in two ways. No doubt
the serious issue of organ donation is a “High Involvement” process. So the two different
ways arise due respective chronology of “Feeling” and “Thinking” involved.

1. Informative
Making people aware of the cause and then inciting the feelings in them. The process
in the case of product purchase is designated as more or less to be “economical”. But
in this case of a social issue rather than a product, we can call the process analytical,
where people learn about the issue, get moved by it and then decide to do their bit
for the cause
2. Affective
But more effective cases are those, in people experience the issue at a personal level
first, they get motivated to learn about it and try to gather information on their own
or if exposed to related information are affected more because they already feel
about it. In such cases, chances of people turning in for donation increase
dramatically

The multi-touch point campaign, which follows, attempts to address both the processes.

Attitude Commitment
According to attitude commitment model the different levels can be visualized as:

Targeting of Groups
Cadaver organ donation being an issue related to taboo topic of “Death”, can be made more
relevant and thought provoking if the people are targeted in groups. In groups people tend
to shun their concern and doubts related to fear and psyche.
The Campaign: Life after Death

The usual connotation that the campaign name has is related to supernatural experiences
that people claim to have in near death experiences. But the campaign will aim at real,
factual life possibilities for many other after death of an individual.

Objectives
1. To increase awareness in people (targeting them young) about brain death and
cadaver organ donation
2. To promote and effect organ donation drives in partnership with NGOs and
hospitals
3. To create a conscientious community of individuals who believe in this noble
cause

Execution
1. Channels
A multi-channel approach would need utilization of all popular modes of
broadcasting and communication channels and networks:

o Web campaigns can be led by campaign website (introducing the

concept)
o Television campaigns in form of short films, social advertising and talk
shows with experts
o Print campaigns by getting associated with magazines and newspapers
to print stories related to cadaveric organ donation

2. Organ Donation Drives

Getting associated with colleges, schools and industries, with help of NGOs, in
arrangement of one day programs about awareness and pledging the organ
donation.

3. Networking between Hospitals

The campaign will also network hospitals so that in case of a possible donor and a
possible receiver, the communication is quick and thus organs could be extracted
and transferred as soon as possible

Storyboard for TV campaign

1. A slide show about facts related to organ transplant seekers and state of affairs in
India:
“There are almost 3 to 4 lac people who require a kidney to live their lives”
“Out of these, only around 15 to 20 will stand a chance of getting an organ from a
cadaver, a deceased person whose organs could be donated”
 “India has among the world’s highest number of deaths from road accidents. In more
than 50% cases, victims are brain dead”
“Yet organ donation from the deceased is miniscule 0.05 per million people”
“In the US and Hong Kong, it is 25 per million and 5 per million respectively”

2. Excerpts from 2-3 people who have been benefited by organ donation.
This has got to move audience. So it should consist of how desperate were they for
an organ transplant and how grateful are they to their donor. Consequently excerpts
from relatives of donors would also be captured emphatically.

3. Short clips of youth and old alike from different geographies pledging to donate
organs.
“I pledge my organs after my death”
“Because I believe in Life after death. Do you?”

Concept of a Short Film: Vardhman

When Vardhman was born 8 years after his parents’ marriage and he was just like
any normal baby in most ways. The only difference was that he was born with a rare
neurological disorder. He succumbed to jaundice just after his birth and spent 3
months in the hospital recovering from a critical condition.
Vardhman grew up like any other child. He was a very dear child to his parents and
his grandmother. He was popular among the neighbors. He loved to play football. He
had a brilliant IQ which many times didn’t reflect in the mark sheets. Instead it
would reflect in his songs which he would make and sing. He was inquisitive and the
reach of his mind was widening with each passing year of his life.
But little did anybody know that with the same speed his brain cells were being
destroyed by a rare neurological disorder. And it was in the 8th year of his life when
everyone started seeing the effects of that disorder. His mental age was going
behind. And his immunity was getting affected. And there was no cure.
It didn’t take long when life took a heartless turn. He was diagnosed with a liver
infection and it was difficult to recover from it. He has to be admitted to a hospital.
In the hospital, the doctor discusses Vardhman case history with his father and
specialists. He tells them how this mental disorder had started eating his brain cells
and his mental growth stunted. His immunity also got affected and his nervous
system became weak. The doctors are unable to give any hope as the liver damage
is worsening with each passing day. His father gets really worried now.
Meanwhile Vardhman talks to other patients in his ward while his mother takes care
of him. Vardhman plays and sings. And then he tells his mother to get his favorite
cuisine. After Vardhman sleeps his mother talks to the parents of fellow patients and
tells them about Vardhman’s early childhood.
At home his grandmother prays for her grandson. She calls a pandit who does poojas
and hawans for his recovery. He gives holy liquid to grandmother for Vardhman. The
grandmother gives it to the father who while believing in the gods, still doesn’t easily
fathom the idea of these holy liquid.
Doctors tell Vardhman’s father that his lever is getting damaged very fast and he
needs a transplant if he has to survive. But they are not sure if it would be possible
in his case and they tell him about the disorder and the extent to which it has
damaged his brain and nervous system. Vardhman’s father is aghast and requests
the doctor to find a way. The doctors say they will try their best to find a solution.
Vardhman’s parents talk to the parents of other patients and get to know about their
story which really moves them. The other parents tell them how they tried to even
buy an organ but couldn’t succeed. They say that they could do anything to save
their child, even sell their houses. They say it’s very painful to watch their kids
suffering and dying in front of their eyes when they could be saved by someone’s
generosity. A patient is also there whose father is a rigid and conservative person.
He doesn’t participate in the discussion and doesn’t support the idea of organ
transplant as it is against his religion. He is ready to sacrifice his son even when he
loves him, for his religious beliefs.
The next day while talking to the doctors he meets people from the NGO which
works in organ donation. He gets to know how the plight of patients waiting for new
organs. He is deeply moved for the first time in his life.
Vardhman gets serious and goes into coma. The doctors tell his father that it’s just a
matter of time before Vardhman dies. The liver has stopped functioning. And the
nervous system is also failing. He could be brain dead anytime. He asks if anything
can be done. The doctors say nothing can be done now. It’s his last stage.
His father tells at home about his condition. Everyone is tensed and without hope. He
also tells that one of the patients in Vardhman’s ward died for want of organ and it
has really disturbed him. The pundits oppose the idea of organ transplant. They say
it is not natural and it doesn’t free the soul of the donor person after his death. After
death the whole body must return to its elements.
Vardhman sinks and doctors declare him brain dead and keep him on ventilator. His
mother thinks he would still live. The parents are deeply hurt by the situation. As
they pass through the lobby in the hospital, he gets to meet one person from the
same NGO who gives his condolences and leaves. His father breaks the news to the
family members and tells them that he has decided to donate the organs (the
mother gives the idea). The grandmother and the pandit oppose but the parents
convince the grandmother somehow.
The formalities are completed and the organs are removed. The parents leave with
the dead body and the whole hospital staff gives them a salute and a warm and
emotional farewell. Vardhman’s organs are transferred to the people who need them
and Vardhman is buried. They convince the father to accept the organ and gift a life
to his son rather than being rigid.
People organize movements to spread Vardhman’s deeds. His paintings are displayed
which now show their true meanings. Year after year people who get benefited by
this drive gather in an annual event to pay their homage to the greatest hero they
know.
It was truly a gift which lived on forever.
References
1. http://doctor.ndtv.com/storypage/ndtv/id/3774/type/feature/Cadaver_organ_donati
on_in_India.html?cp
2. http://www.chillibreeze.com/articles_various/Organ-Donation.asp
3. http://organdonationindia.blogspot.com
4. CHETNA Foundation
5. MOHAN Foundation
6. Classroom presentations by Prof. A Unnithhan
7. Bibliography: Consumer Behavior by Michael R. Solomon