A Qualitative Analysis of Religion’s Influence on Organ Donation Process

Öz

One of the most important problems with organ transplantation, which is a form of treatment that improves or saves the lives of many people today, is the inadequacy in the number of organ donations. Since the organ donation is an altruistic and pro-social behavior, increasing the number of donations is important for strengthening social solidarity as well as patients. Most of the related studies show that religion influences attitudes and behaviors toward organ donation, but few of them are based on qualitative research. The aim of this study is to evaluate how religion shapes the decision-making process for organ donation, based on the data of a qualitative study completed in 2021, and to interpret the process sociologically without reducing the complexity of the process to a cause-effect relationship. Data were collected through semi-structured interviews from 18 participants. The sample was selected with maximum diversity and snowball sampling techniques. This study concludes that religion shapes the organ donation process in a multidimensional and multidirectional way, which should not be handled within the framework of direct and negative causality.

Anahtar Kelimeler

• Sociology
• Sociology of Religion
• Organ Donation
• Organ Transplantation
• Qualitative Method

Organ Bağışı Sürecinde Dinin Etkisinin Nitel Perspektifle İncelenmesi

Öz

Günümüzde pek çok insanın yaşamını iyileştiren veya kurtaran bir tedavi şekli olan organ nakli ile ilgili en önemli sorunlardan biri organ bağış sayısındaki yetersizliktir. Organ bağışı özgeci ve toplum yanlısı bir davranış olduğu için bağış sayısının artması hastalar için olduğu kadar toplumsal dayanışmanın güçlendirilmesi açısından da önemlidir. Organ bağışı kararı konusunda yapılan çalışmaların büyük kısmı dinin organ bağışına yönelik tutum ve davranışları etkilediğini göstermekte, ancak pek azı nitel araştırmalara dayanmaktadır. Bu çalışmanın amacı 2021 yılında tamamlanan nitel bir araştırmanın verileri üzerinden dinin organ bağışına karar verme sürecini nasıl şekillendirdiğini değerlendirmek ve sürecin karmaşıklığını bir neden sonuç ilişkisine indirgemeden sosyolojik olarak yorumlamaktır. Veriler, maksimum çeşitlilik ve kartopu örnekleme teknikleriyle seçilmiş olan 18 katılımcıdan yarı yapılandırılmış mülakatlarla toplanmıştır. Bu çalışmada dinin organ bağışı sürecini çok boyutlu ve çok yönlü olarak şekillendirdiği, bu etkinin doğrudan ve olumsuz bir nedensellik çerçevesinde ele alınmaması gerektiği sonucuna varılmıştır.

Anahtar Kelimeler

• Sosyoloji
• Din Sosyolojisi
• Organ Bağışı
• Organ Nakli
• Nitel Yöntem

Kaynakça

1. Adidi, Walid A. ve Chris Morse. “Expanding The Role of Emotion in the Theory of Motivated Information Management.” Uncertainty, Information Management, and Disclosure Decisions: Theories and Applications, ed. Tamara Dawn Afifi ve Walid A. Afifi, içinde 87-105. London: Routledge, 2009.
2. Aghaee, Monavar Afzal, Mina Dehghani, Mehran Sadeghi ve Esmaeil Kaleghi. “Awareness of Religious Leaders' Fatwa and Willingness to Donate Organ.” International Organ Transplantation Medicine 6:4 (2015): 158-164.
3. Ahmed, Mustafa, Paul Kubilis ve Aasim Padela. “American Muslim Physician Attitudes Toward Organ Donation.” Journal of Religion and Health 57:5 (2018): 1717-1730.
4. Ajzen, Icek. “The Theory of Planned Behavior.” Organizational Behavior and Human Decision Processes 50:2 (1991): 179–211.
5. Al-Faqih, Salah R. “The Influence of Islamic Views on Public Attitudes Towards Kidney Transplant Donation in a Saudi Arabian Community.” Public Health 105:2 (1991): 161-165.
6. Ali, Abeera, Tibyan Ahmed, Ali Ayub, Sumaya Dano, Maroof Khalid, Noor El-Dassouki, Ani Orchanian-Cheff, Shabbir Alibhai ve Istvan Mucsi. “Organ Donation and Transplant: The Islamic Perspective.” Clinical Transplantation 34:4 (2020): 1-13.
7. Al-Khader, Abdullah, Feroze Shaheen ve Mohamed Al-Jondeby. “Important Social Factors that Affect Organ Transplantation in Islamic Countries.” Experimental and Clinical Transplantation 1:2 (2003): 96-101.
8. Alkhawari, Fawzi, Gerry Stimson ve Anthony Warrens. “Attitudes Toward Transplantation in UK Muslim Indo-Asians in West London.” American Journal of Transplantation 5:6 (2005): 1326-1331.

9. Alsalem, Amani, Scott Weaven ve Park Thaichon. “Theoretical Insights into Organ Donation and Social Change.” Entrepreneurship and Organizational Change, ed. Vanessa Ratten, içinde 149-166. Cham (Almanya): Springer, 2020.
10. Ashkenazi, Tamar, Marius Berman, Sharona Ben Ami ve Abed Fadila. “A Bridge Between Hearts: Mutual Organ Donation by Arabs and Jews in Israel.” Transplantation 77:1 (2004): 151-155.
11. Ashraf, Omer, Saad Ali, Sumbul Ali, Hina Ali, Mehrulnisa Alam, Arshad Ali ve Talaha Ali. “Attitude Toward Organ Donation: A Survey in Pakistan.” Artificial Organs 29 (2005): 899-905.
12. Aykaş, Ahmet, Aykut Uslu ve Sait Murat Doğan. “Intellectuality and Attitudes of Clergy About Organ Donation in Turkey: Metasynthesis Of Observational Studies.” Transplantation Proceedings 47:4 (2015): 1066-1069.
13. Balcı, Elçin ve Mehtap Şahingöz. “Hemşirelerin Organ Bağışına Bakışları.” Cumhuriyet Tıp Dergisi 36:4 (2014): 503-511.
14. Bandura, Albert. “Social Cognitive Theory: An Agentic Perspective.” Annual Review of Psychology 52:1 (2001): 1–26.
15. Barcellos, Franklin, Cora Luiza Araujo ve Juvenal Dias da Costa. “Organ Donation: A Population Based Study.” Clinical Transplantation 19 (2005): 33-37.
16. Başal, Bilgen. “Türkiye’de Organ Bağışı Oranlarının Düşük Olma Sebepleri ve Çözüm Önerileri: Bir Saha Çalışması.” The Journal of Academic Social Science Studies 33 (2015): 207-221.
17. Bilgel, Halil, Ganime Sadıkoğlu, Olgun Göktaş ve Nazan Bilgel. “A Survey of The Public Attitudes Towards Organ Donation in a Turkish Community and of The Changes that Have Taken Place in the Last 12 Years.” Transplantation International 17 (2004): 126-130.
18. Bilgel, Halil, Ganime Sadıkoğlu, Olgun Göktaş ve Nazan Bilgel. “Public Attitudes Toward Organ Donation. A Survey in a Turkish Community.” Transplantation International 4 (1991): 243-245.
19. Bokek-Cohen, Ya’arit, Riad Abu-Rakia, Pazit Azuri ve Mahdi Tarabeih. “The View of the Three Monotheistic Religions Toward Cadaveric Organ Donation.” OMEGA- Journal of Death and Dying 85:2 (2022): 429-444.
20. Boulware, Ebony, Lloyd Ratner, Lisa Cooper, Julie Ann Sosa, Thomas LaVeist ve Neil Powe. “Understanding Disparities in Donor Behavior: Race And Gender Differences in Willingness to Donate Blood and Cadaveric Organs.” Medical Care 40 (2002): 191-198.
21. Bourdieu, Pierre. “The Forms of Capital.” Handbook of Theory and Research for the Sociology of Education, ed. John Richardson, içinde 241–258. New York: Greenwood, 1986.
22. Bruzzone, Paolo. “Religious Aspects of Organ Transplantation.” Transplantation Proceedings 40 (2018): 1064-1067.
23. Bulut, Aliye. “İlahiyat Fakültesi Öğrencilerinin Organ Bağışı Hakkında Bilgi, Tutum ve Davranışları.” Kocaeli Medical Journal 8:1 (2019): 202-209.
24. Can, Fatma. “Organ Bağışına Onay Veren ve Vermeyen Ailelerin Bazı Sosyal Psikolojik Değişkenler Yönünden Karşılaştırılması.” Doktora Tezi, Ankara Üniversitesi, Ankara, 2016.
25. Coleman, James Samuel. Foundations of Social Theory. London: Harvard University Press, 1990.
26. Coletta, Nat ve Michelle Cullen. The Nexus Between Violent Conflict, Social Capital and Social Cohesion: Case Studies from Cambodia and Rwanda. Washington DC: The World Bank, 2000.
27. Cronin, Antonia J. ve James Douglas. “Directed and Conditional Deceased Donor Organ Donations: Laws and Misconceptions.” Medical Law Review 18:3 (2010): 275-301.
28. Derviş, Sıla. “Promoting Organ Donation Through Mortality Salience for Different Levels and Orientations of Religiosity.” Yüksek Lisans Tezi, Orta Doğu Teknik Üniversitesi, Ankara, 2015.
29. Dolfsma, Wilfred, Rene van der Eijk ve Albert Jolink. “On a Source of Social Capital: Gift Exchange.” Journal of Business Ethics 89:3 (2008): 315-329.
30. Einollahi, Behzad, Mohammad Hossein Nourbala, Saeid Bahaeloo-Horeh, Shervin Assari, Mahboob Lessan-Pezeshki ve Naser Simforoosh. “Deceased-Donor Kidney Transplantation in Iran: Trends, Barriers And Opportunities.” Indian Journal of Medical Ethics 4:2 (2007): 70-72.
31. Eldegez, Cumhur Uluğ ve Yalçın Seyhun. “Türkiye'de ve Dünyada Transplantasyonun Tarihçesi.” Türkiye Klinikleri Journal General Surgical Special Topics 6:1 (2013): 1-6.
32. Ertin, Hakan. “Organ Bağışı ve Transplantasyon Tıbbı: Etik Çerçeve ve Çözüm Tartışmaları.” İş Ahlakı Dergisi 7:2 (2014): 91-120.
33. Gauher, Salman T, Ravi Khehar, Gaurav Rajput, Alia Hayat, Bhavagaya Bakshi, Hanmeet Chawla, Benita Cox ve Anthony Warrens. “The Factors that Influence Attitudes Toward Organ Donation for Transplantation Among UK University Students of Indian and Pakistani Descent.” Clinical Transplantation 27:3 (2013): 359-367.
34. Gill, Paul ve Lesley Lowes. “Gift Exchange and Organ Donation: Donor and Recipient Experiences of Live Related Kidney Transplantation.” International Journal of Nursing Studies 45:11 (2008): 1607-1617.
35. Global Observatory on Donation and Transplantation. http://www.transplant-observatory.org/summary/ (24.02.2022). Guba, Egon ve Yvonna Lincoln. “Epistemological and Methodological Bases of Naturalistic Inquiry.” Educational Communication and Technology Journal 30:4 (1982): 233-252.
36. Güden, Emel, Fevziye Çetinkaya ve Melis Naçar. “Attitudes and Behaviors Regarding Organ Donation: A Study on Officials of Religion in Turkey.” Journal of Religion and Health 52:2 (2013): 439-449.
37. Gürdil Yılmaz, Seher, Burcu Opak Yücel ve Döndü Çuhadar. “Knowledge and Attitudes of The Faculty of Theology Students on Organ Transplantation.” Journal of Religion and Health 56:3 (2017): 1042-1051.
38. Gürler, Hesna ve Ayşe Topal Hançer. “Bir Aile Sağlığı Merkezine Başvuran Bireylerin Organ Bağışı Konusundaki Tutumları.” Türkiye Klinikleri Journal of Medical Ethics-Law and History 28:1 (2020):90-98.
39. Hanto, Douglas W. “Ethical Challenges Posed by The Solicitation of Deceased and Living Organ Donors.” The New England Journal of Medicine 356:10 (2007): 1062-1066.
40. Hayward, Claire ve Anna Madill. “The Meanings of Organ Donation: Muslims of Pakistani Origin and White English Nationals Living in North England.” Social Science and Medicine 57:3 (2003): 389-401.
41. Hyde, Melissa K. ve Katherine M. White. “Young Australian Adults’ Knowledge and Beliefs About Organ Donation.” Progress in Transplantation 17 (2007): 220-227.
42. Irving, Michelle J, Alison Tong, Stephen Jan, Alan Cass, John Rose, Steven Chadban, Richard D Allen, Jonathan C Craig, Germaine Wong ve Kirsten Howard. “Factors that Influence the Decision to be an Organ Donor: a Systematic Review of Qualitative Literature.” Nephrology, Dialysis, Transplantation 27:6 (2012): 2526-2533.
43. Kahneman, Daniel ve Amos Tversky. “Choices, Values, and Frames.” Handbook Of The Fundamentals of Financial Decision Making, ed. Leonard C. Maclean ve William T. Ziemba, içinde 268-278. Hackensack: World Scientific, 2013.
44. Kamrul Islam, Mohammad, Juan Merlo, Ichiro Kawachi, Martin Lindström ve Ulf Göran Gerdtham. “Social capital and health: Does egalitarianism matter? A literature review.” International Journal for Equity in Health 5:3 (2006): 1–28.
45. Kanellopoulou, Nadja. “Reconsidering Altruism: Introducing Reciprocity and Empowerment in the Governance of Biobanks.” Principles and Practice in Biobank Governance, ed. Jane Kaye ve Mark Stranger, içinde 33-52. Farnham: Ashgate, 2009.
46. Kawachi, Ichiro, Sankaran V. Subramanian ve Daniel Kim. “Social Capital and Health: a Decade of Progress and Beyond.” Social Capital and Health, ed. Ichiro Kawachi, S Sankaran V. Subramanian ve Daniel Kim, içinde 1–29. New York: Springer, 2008.
47. Keçecioğlu, Nilgün, Murat Tuncer, Levent Yücetin, Mustafa Akaydın ve Gülşen Yakupoğlu. “Attitudes of Religious People in Turkey Regarding Organ Donation and Transplantation.” Transplantation Proceedings 32:3 (2000): 629-630.
48. Keten, Hamit Sırrı, Derya Keten, Hüseyin Üçer, Mustafa Cerit, Oğuz Işık, Ökkeş Hakan Miniksar ve Özgür Ersoy. “Knowledge, Attitudes and Behaviors of Mosque Imams Regarding Organ Donation.” Annals of Transplantation 19 (2014): 598-603.
49. Korkmaz, Sezai. “Organ Bağışı Tutumları ve Dindarlık İlişkisi.” Amasya İlahiyat Dergisi 15: (2020): 493-516.
50. Krupic, Ferid. “The Impact of Religion and Provision of Information on Increasing Knowledge and Changing Attitudes to Organ Donation: An Intervention Study.” Journal of Religion and Health 59 (2020): 2082–2095.
51. Ladin, Keren. “Does Social Capital Explain Community-Level Differences in Organ Donor Designation?” Milbank Quarterly 93:3 (2015): 609-641.
52. Lam, Wilbur Aaron ve Laurence McCullough. “Influence of Religious And Spiritual Values Of The Willingness of Chinese-Americans to Donate Organs For Transplantation.” Clinical Transplantation 14 (2000): 449-456.
53. Locock, Lousie ve Lorraine Smith. “Personal Benefit, or Benefitting Others? Deciding Whether to Take Part in Clinical Trials.” Clinical Trials 8 (2011): 85-93.
54. Machin, Laura L. ve Leonid Cherkassky. “Deconstructing Donation.” Journal of Medical Law and Ethics 3:3 (2015): 145-147. Mauss, Marcell. The Gift: The Form and Reason for Exchange in Archaic Societies. Londra: Routledge, 1990.
55. Miah, Ti, Grace C Hillyer, S Ali Husain ve Sumit Mohan. “Cultural Barriers to Organ Donation Among Chinese and Korean Individuals in the United States: A Systematic Review.” Transplant International 32:10(2019): 1001-1018.
56. Moazam, Farhat, Aamir Jafarey ve Bushra Shirazi. “To Donate a Kidney: Public Perspectives from Pakistan.” Bioethics 28:2 (2014): 76-83.
57. Mohamed, Elagba. “Public Awareness Survey About Organ Donation and Transplantation.” Transplantation Proceedings 45:10 (2013): 3469-3471.
58. Mossialos, Elias, Joan Costa-Font ve Caroline Rudisill. “Does Organ Donation Legislation Affect Individuals’ Willingness to Donate Their Own or Their Relative’s Organs? Evidence from European Union Survey Data.” BMC Health Services Research 8:48 (2008): 1-10.
59. Muliira, Rhoda S. ve Joshua K. Muliira. “A Review of Potential Muslim Organ Donors' Perspectives on Solid Organ Donation: Lessons for Nurses in Clinical Practice.” Nursing Forum 49:1 (2014): 59-70.
60. Naçar, Melis, Fevziye Çetinkaya, Dilek Kanyılmaz, Bülent Tokgöz ve Cengiz Utaş. “Hekim Adaylarının Organ Nakline Bakış Açıları.” Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 10:2 (2001): 123-128.
61. Naçar, Melis, Fevziye Çetinkaya, Zeynep Baykan ve Serpil Poyrazoğlu. “Attitudes and Behaviours of Students from the Faculty of Theology Regarding Organ Donation: A Study from Turkey.” Transplant Proceedings 41:10 (2009):4057-4061.
62. Nahapiet, Janine ve Sumantra Ghoshal. “Social Capital, Intellectual Capital, and the Organizational Advantage.” Academy of Management Review 23:2 (1998):242-266.
63. Najafizadeh, Katayoun, Fariba Ghorbani, Sajjad Hamidinia, Mohammad Ali Emamhadi, Mohammad Ali Moinfar, Omid Ghobadi ve Shervin Assari. “Holy Month of Ramadan and Increase in Organ Donation Willingness.” Saudi Journal of Kidney Diseases and Transplantation 21 (2010): 443-446.
64. National Health System. “An Islamic Perspective on Organ Donation.” https://www.orgando-nation.nhuk/helping-you-to-decide/your-faith-and-beliefs/islam/ (22.02.2022).
65. Okka, Berrin ve Orhan Demireli. “Konya İlinde Halkın Organ Bağışı Konusuna Bakış Açılarının Değerlendirilmesi.” Türkiye Klinikleri Journal of Medical Ethics 16:3 (2008): 148-158.
66. Oliver, Eva, Gabriel Moreno ve Josep Maria Grinyo. “Anonymity of Organ Donors Under Discussion.” Italian Journal of Nephrology 36:6 (2019): 1-5.
67. Oliver, Michael, Alexander Woywodt, Aimun Ahmed ve Imran Saif. “Organ Donation, Transplantation and Religion.” Nephrology, Dialysis, Transplantation 26:2 (2011): 437-444.
68. Özbolat, Abdullah. “Organlarımla Dirilmek İstiyorum: Organ Bağışının Dini-Toplumsal Arkaplanı.” Çukurova Üniversitesi İlahiyat Fakültesi Dergisi 17:1 (2017): 61-87.
69. Özer, Ali, Hasan Çetin Ekerbiçer, Mustafa Çelik ve Melis Naçar. “Knowledge, Attitudes, and Behaviors of Officials of Religion About Organ Donation in Kahramanmaras, an Eastern Mediterranean City of Turkey.” Transplant Proceedings 42:9 (2010):3363-3367.
70. Padela, AAsim I. ve Hatidza Zaganjor. “Relationships between Islamic Religiosity and Attitude Toward Deceased Organ Donation Among American Muslims: A Pilot Study.” Transplantation 97:12 (2014): 1292-1299.
71. Padela, AAsim I. ve Jasser Auda. “The Moral Status of Organ Donation and Transplantation within Islamic Law: The Fiqh Council of North America's Position.” Transplantation Direct 18:6 (2020): 1-7.
72. Padela, AAsim, Shoaib Rasheed, Gareth J W Warren, Hwajung Choi ve Amit K Mathur. “Factors Associated with Positive Attitudes Toward Organ Donation in Arab Americans.” Clinical Transplantation 25:5 (2011): 800-808.
73. Pichon, Isabelle ve Vassilis Saroglou. “Religion and Helping: Impact of Target, Thinking Styles and Just-World Beliefs.” Archive for the Psychology of Religion 31 (2009): 215-236.
74. Putnam, Robert D., Robert Leonardi ve Rafaella Y. Nanetti. Making democracy work: Civic traditions in modern Italy. Princeton: Princeton University Press, 1993.
75. Sanal, Aslıhan. Yeni Organlar, Yeni Hayatlar- Organ Nakli, Ahlak ve Ekonomi. İstanbul: Metis, 2013.
76. Saroglou, Vassilis. “Din, Maneviyat ve Diğerkâmlık.” Çev. Meryem Şahin. Çanakkale On sekiz Mart Üniversitesi İlahiyat Fakültesi Dergisi 7 (2015): 113-145.
77. Shaheen, Faissal M. ve Mohammed Ziad Souqiyyeh. “Increasing Organ Donation Rates from Muslim Donors: Lessons from a Successful Model.” Transplantation Proceedings 36:7 (2004): 1878-1880.
78. Sharif, Adnan, Haifaa Jawad, Peter Nightingale, James Hodson, Graham Lipkin, Paul Cockwell, Simon Ball ve Richard Borrows. “A Quantitative Survey of Western Muslim Attitudes to Solid Organ Donation.” Transplantation 92:10 (2011): 1108-1114.
79. Sharp, Chloe ve Gurch Randhama. “Social Capital and Deceased Organ Donation.” Social Indicators Research 157:4 (2012): 115-140.
80. Sharp, Chloe ve Gurch Randhawa. “Altruism, Gift Giving and Reciprocity in Organ Donation: A Review of Cultural Perspectives and Challenges of the Concepts.” Transplantation Reviews 28 (2014): 163-168.
81. Sharp, Chloe ve Gurch Randhawa. “The Potential Role of Social Capital in the Willingness to be a Deceased Organ Donor: A Case Study of UK Polish Migrants.” Transplantation Proceedings 48:3 (2016): 680-688.
82. Şantaş, Gülcan ve Fatih Şantaş. “Türkiye’de Organ Bağışının Mevcut Durumu ve Organ Bağışında Stratejik İletişimin Önemi.” SDÜ Sağlık Bilimleri Enstitüsü Dergisi 9:2 (2018): 163-168.
83. Tarhan, Merve, Levent Dalar, Hüseyin Yıldırımoğlu, Adnan Sayar ve Sedat Altın. “The View of Religious Officials on Organ Donation and Transplantation in the Zeytinburnu District of Istanbul.” Journal of Religion and Health 54:6 (2015): 1975-1985.
84. Titmuss, Richard Morris. The Gift Relationship. Londra: Allen & Unwin. 1970.
85. Topbaş, Murat, Gamze Çan, Mehmet Ali Çan ve Şükrü Özgün. “Outmoded Attitudes Toward Organ Donation Among Turkish Health Care Professionals.” Transplantation Proceedings 37 (2005): 1998-2000.
86. Traunmüller, Richard. “Moral Communities? Religion as a Source of Social Trust in a Multilevel Analysis of 97 German Regions.” European Sociological Review 27:3 (2011): 346-363.
87. Tumin, Makmor, Abdillah Noh, Nurulhuda Mohd Satar, Chong Chin-Sieng, Lim Soo-Kun, Nawi Abdullah ve Ng Kok-Peng. “Organ Donation in Muslim Countries: The Case of Malaysia.” Annals of Transplantation 18:1 (2013): 671-676.
88. Uskun, Ersin ve Mustafa Öztürk. “Attitudes of Islamic Religious Officials Toward Organ Transplant and Donation.” Clinical Transplantation 27:1 (2013): 37-41.
89. Van Pachterbeke, Matthieu, Christopher Freyer ve Vassilis Saroglou. “When Authoritarianism Meets Religion: Sacrificing Others in the Name of Abstract Deontology.” European Journal of Social Psychology 41 (2011): 898–903.
90. Vojnov, Teodora. “A Sociological Perspective on Organ Transplantation and Donation in Serbia.” Yüksek Lisans Tezi, Lund University, Lund, 2021.
91. World Population Review. “Country Rankings.” https://worldpopulationreview.com/country-rankings/most-christian-countries (13.10.2022).
92. Yalçın Balçık, Pınar, Gamze Yorgancıoğlu Tarcan ve Bülent Sapaz. “Attitudes’ of University Students Towards Organ Donation and Transplantation.” SDÜ Sağlık Bilimleri Dergisi 10:3 (2019): 314-319.