Entertainment (Mis)Education: The Framing of Organ Donation in Entertainment Television

Abstract

Researchers and practitioners who have sought to understand public reluctance to donating organs in spite of favorable attitudes toward organ donation have long thought that belief in myths about donation contribute to the problem. How these myths emerged and more important, why they have persisted in spite of national education campaigns is not clear. In the absence of direct personal experience with organ donation or transplantation, we believe that most people receive their information about donation through the media. In this study, we identify all entertainment television shows with organ donation storylines or subplots broadcast on ABC, NBC, CBS, and FOX from 2004–2005. Frame analysis reveals 2 competing metaframes: the moral corruption of the powerful and organ donors are good people. In addition to the metaframes, 4 secondary frames, and 6 tertiary frames are identified. Organ donation is framed in mostly negative terms, with a few notable exceptions. Recommendations for how to address negative framing of organ donation in the media are offered.

ACKNOWLEDGMENTS

This study was supported by grant No. 1 H39 OT 000120-03 from the Health Resources and Services Administration's Division of Transplantation (HRSA/DOT), U.S. Department of Health and Human Services. The contents of this article are solely the responsibility of the authors and do not necessarily represent the views of HRSA/DOT.

Notes

¹Black markets for human organs are extremely unlikely in the United States for several reasons. First, transplant surgery is highly intricate and requires that the designated transplant recipient be surgically prepared to receive the organ at the same time the organ is being procured from the donor. Second, organs must be matched by tissue type, among other things. Black market “butchers” have no way of doing this type of matching before murdering people and then selling the organs (presumably to people who have also not tissue-typed themselves). Third, hospitals and transplant surgeons simply would not accept an undocumented organ that has not gone through The United Network for Organ Sharing (UNOS) matching system. Loss of accreditation, criminal charges of accessory to murder, and lawsuits are among the potential consequences. However, illegal living transplants are not uncommon in other parts of the world, and efforts by the United Nations are under way to curb the trafficking in human organs. It should be noted that many Americans are among those who are going overseas to get living donor transplants from desperately poor people in a number of developing countries.

²The organ procurement field distinguishes between cardiac death and brain death for transplant purposes, with brain death being the most viable option for transplantation. In cardiac death, the heart stops beating and the body can no longer sustain life. Cardiac death is probably more closely aligned with common perceptions of death than brain death. Brain death represents the complete and total cessation of brain functions, including involuntary responses and control of the autonomic nervous system. When a patient is brain dead, he or she is placed on mechanical support to keep organs viable for transplantation. Both cardiac death and brain death represent “real death” and there is no recovery from brain death.

³The decision to add a patient to a transplant waiting list is made by a hospital committee, not a single doctor, and is made based on a list of medical and other criteria. This episode also plays on the notion that one doctor alone can have the power to determine who does or does not receive a transplant.

⁴As of this writing, Hollywood, Health, and Society has been engaged to conduct outreach with television writers and producers. Thus far, they have been able to provide consulting services for two episodes of entertainment programs.