This study examined mothers who have undergone gamete donation treatment and lack a genetic connection to their adolescent children. The study examined the mothers experience of closeness and similarity with their child, as well as their feelings regarding the child's ability to seek information and contact the donor. Experiences regarding talking to the child and others, as well as their potential desire for support were explored. The study is based on data from the longitudinal study Swedish Study of Gamete Donations (SSGD), which has collected data in five rounds since 2005. Using a mixed-methods design the current study compared egg donation mothers in heterosexual couples (n=41) and non-carrying mothers in lesbian couples (n=59). Participants responded to surveys containing rating scales and free text responses. The material was analyzed using chi2-, Mann-Whitney U-, and t-tests, as well as qualitative content analysis. The majority in both groups reported high levels of closeness to their children and more often perceived similarity in personality than appearance. Participants primarily reported positive emotions related to their child’s ability to access information about and contact the donor. There were no statistically significant differences between the groups. Some qualitative differences emerged regarding feelings about discussing the donation. A few mothers from both groups expressed a need for support. The study contributes to a broader understanding of mothers who have undergone gamete donation treatment and how interventions for these mothers can be devised. Additionally, the study confirms that these groups generally have close relationships with their children. / Studien har undersökt mammor som genomgått donationsbehandling och inte har genetisk koppling till sitt, idag tonåriga, barn. Studien undersökte mammornas upplevelse av närhet och likhet med sitt barn samt vilka känslor de har inför barnets möjlighet att söka information och ta kontakt med donatorn. Även upplevelser kring att prata med barnet och andra om donationen samt vilket eventuellt stöd mammorna önskar undersöktes. Studien bygger på data från den longitudinella studien Swedish Study of Gamete Donations (SSGD) som samlat in data i fem omgångar sedan 2005. Studien använde en mixad design för att jämföra grupperna äggdonations-mammor i heterosexuella par (n=41) och icke-bärande mammor i lesbiska par (n=59). Deltagarna har besvarat enkäter som innehöll skattningsskalor och öppna frågor. Materialet analyserades genom chi2-, Mann-Whitney U-, och t-test samt kvalitativ innehållsanalys. Majoriteten i båda grupperna upplevde hög nivå av närhet till sina barn och upplevde oftare likhet i personlighet än utseende. Deltagarna rapporterade primärt positiva känslor relaterade till barnens möjlighet till information om och kontakt med donatorn. Det fanns inga statistiskt signifikanta skillnader mellan grupperna. Dock fanns vissa kvalitativa skillnader gällande känslor och motivation till att prata om donationen. Ett fåtal mammor ur båda grupperna efterfrågade stöd. Studien bidrar till en bredare förståelse för mammor som genomgått donationsbehandling och hur insatser för dessa kan utformas samt bekräftar att dessa grupper generellt har nära relationer till sina barn.

Bakgrund: Över hela världen råder det brist på organ. 1 januari 2019 stod 807 personer på väntelistan för att få ett nytt organ i Sverige. Efterfrågan på organ är större än tillgången. Efterfrågan skulle kunna tillmötesgå bättre om DCD (eng. Donation after Circulatory Death) kan implementeras som ett komplement till DBD (eng. Donation after Brain Death). Det har pågått ett pilotprojekt på sex olika sjukhus i Sverige.Måletmed projektet var att utreda om DCD i framtiden kan vara ett komplement till den idag etablerade donationsprocessen DBD vilket leder till att sjukvården kan möta allmänhetens donationsvilja samt öka antalet organ för transplantation. Då DCD inte är nationellt implementerat och genom att intensivvårdssjuksköterskor har ansvaret för att vårda potentiella organdonatorer är det viktigt med forskning som belyser intensivvårdssjuksköterskorsresonemang och föreställningar kring DCD.Syfte:Syftet var att beskriva intensivvårdssjuksköterskors resonemang och föreställningar om donation vid kontrollerad DCD.Metod:Kvalitativ intervjustudie med ändamålsenligt urval genomfördes. Data analyserades med kvalitativ innehållsanalys.Resultat:Analysen resulterade i fyra kategorier; Att påbörja något nytt inom området donation, Att erhålla kunskap minskar farhågor och oro, Att införa donation efter cirkulationsstillestånd ger möjlighet att möta en hög donationsvilja och att informera och ge tröst till anhöriga.Slutsats: Denna studie visar att engagemanget är stort hos intensivvårdssjuksköterskor och att tilltron tillett införande av DCD är hög. Genom att införa DCD som ett komplement till DBD så skulle fler donationer kunna genomföras och på sikt kunna matcha efterfrågan på organ. Mer forskning samt utbildning behövs för att öka kunskapen utifrån de krav som kommer att ställas på intensivvårdssjuksköterskor vid en eventuell implementering av DCD.

Donation is not only a transfer of property, but it is a proof of certain relationship between the donor and the donee, which results from the liberality and altruism of the donor. Therefore it is understandable that majority of donations take place in the frame of family relations, they appear almost every day and they present a highly used contractual type in all legal orders. The legal regulation of donation has been significantly extended by the new civil code (Act no. 89/2012 coll. civil code) compared to the previous regulation and therefore is more compact and detailed, it has been also extended of another reason for revocation of donation, namely for impoverishment of the donor, furthermore the donatio mortis causa, which has been forbidden by the previous civil code has returned to the current regulation. In spite of enactment of new regulation some questions remain unsolved or new questions arise which will have to be answered by the currently non-existent specialized literature and judicial decisions. The aim of the submitted diploma thesis was to evaluate, whether the current legal regulation of donation contract can stand in comparison with the other European regulations, contained it civil codes with long-standing tradition whether it exceeds them in some directions, which deficiencies...

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Commentary about solid or whole body part transplantation, transfusion and donation is well documented and has added to discourse about who gives and receives and how. Commentary about another body part – blood – is, it is argued here, less well developed (Sanner, 2001; Lock, 2004; Scheper-Hughes and Wacquant, 2006; Shaw, 2009). Blood and its modern-day sociology and anthropology is understood and limited by its links with both Titmuss’ altruism and gift exchange theories. This thesis, using a qualitative ethnographic approach, re-examines and introduces new discourse about blood, challenging the orthodoxy of altruism and seeking new understanding and justification for blood donation. It uses testimony from 80 blood donors to elicit real-time ideas about blood as a source of risk rather than a gift from strangers. It also argues that donors “give to get back” their donations rather than give as a form of altruistic behaviour, thus introducing the concept that blood donating is a form of covenant between society and the individual or a form of deposit. Issues of trust are examined via the lens of deferment as increasingly it is not good enough to just donate blood without stringent societal, as well as techno-medical, surveillance. Donating blood is shown to be a form of active citizenship, and to be deferred from doing so has a direct impact on individuals’ freedom to donate and thus community membership. The emotional labour of giving is revealed by the testimonies of “able” donors, which evidence that not only do donors perceive their blood to be special, but also the act of giving is a labour carried out by the few who can do it for the majority, in contrast to those donors who regard giving blood to be a mundane, functional practice. Lastly, an emerging hierarchy of self in relation to the body is uncovered here revealing hints at its’ inalienable status. The thesis charts the journey of blood from being a mystical part of the body, linked to goodness, to blood being the new “master tool” of modern society, imbued with risk and therefore entrusted to society via scrutinising blood management systems. The methodological framework is centred on an interpretative approach, using data gathered from interviews and questionnaires from active blood donors in sessions at the National Blood Service (NHSBT) as well as testimony gathered from individual one-to-one interviews. It refers to theories by Foucault, Mauss and Douglas to interpret the qualitative data revealing blood as a target of bio-power, risk management and social exchange and a shifting dislocated new body part, and it sets out to challenge the orthodoxy of altruism as the rationale and justification for blood donation in modern Britain.

ABSTRACT In the HIV/AIDS literature, a perspective that has not received a great amount of attention concerning blood donation per se and the duties and obligations of Blood Transfusion Services (BTS)i when held to the question of fairness raised by socially marginalised persons (or groups) who altruistically wish to donate blood in the face of the HIV/AIDS pandemic is addressed in this research report. The represented marginalised group I use is Men who have Sex with Men (MSM)ii Acquired Immunodeficiency Syndrome, commonly called AIDS first came to the attention of the public in the 1980s. From an unknown unnamed emerging infectious diseaseiii ,it has grown into a pandemic familiar to all. Primarily transmitted either sexually or via contaminated needles, the HIV infected individual is initially an asymptomatic carrier. Once an individual Once an individual is infected with the virus, he or she can pass it on to others by way of body fluids, e.g. blood and semen. HIV, whether treated or not, will eventually develop into AIDS for which there is currently no known cure. AIDS is uniformly mortal. i In this research report, I will refer to the industry as “Blood Transfusion Services” although in some countries it is referred to as “Blood Bank Services” ii Men who have Sex with Men (MSM) according to the London-based PANOS Institute include men who have sex with both men and women, men who have sex with only other men, men who have sex with boys and men, male sex workers and their clients, male transvestites and transsexuals, male street children and men in prison (McKenna 1999:1) iii As defined by Lashley, F, (2006) Emerging Infectious Diseases are ‘diseases of infectious origin whose incidence in humans has increased within the past two decades or threatens to increase in the near future’ The media abounds with literature concerning HIV/AIDS looking at it from various perspectives. iv Moreover, and correctly, in South Africa we are knowledgeable that what once was considered as a threat only to homosexualsv or IV drug users – individuals marginalised by their nonconformance to society’s norms – is now epidemiologically a disease spread in our society primarily by non-drug using heterosexuals. The tension between promoting the public good in the face of an pandemic while simultaneously protecting against unjust discrimination against individuals or groups represents an ethical dilemma faced by all public health organisations including BTS. Principally contextualised in iv e.g. clinical research in, guidelines pertaining to, ethical issues about, legal precedents concerning, duties of medial personnel towards, epidemiological analysis, psychological monitoring …and so on. v At the end of the 19th century, homosexuality was profiled as a mental illness by the German psychiatrist Richard von Krafft-Ebing in his reference book Psychopathis Sexualis.v In the absence of scientific evidence to prove otherwise, this view became widely accepted . Eventually, many different societies perceived homosexuals including MSM as unstable and this reinforced discriminatory practices against them. v Even today, the harmful consequences of homophobia impact on MSM in many different ways. Meyers describes three negative conditions or practices common to the experience of MSM. They are: the internalisation of homophobia to the extent that they accept rejection from society; the experience of social stigmatisation; and overt discrimination and violence.v From some religious aspects, homosexuality is considered a “sin against nature” and is often seen as a link to AIDS, which is again seen as God’s punishment for a “life against nature”.v The Koran suggests punishment for those involved in homosexual acts on the basis of harm to society, and Sharia law admits no tolerance towards homosexuality.v. Predominantly Catholic Latin American countries enforce socio-cultural and legal restrictions to prohibit homosexuality. (Mckenna 1999:11) From Buddhist perspective, homosexuals are not permitted to become a monk and to practice through monk-hood the ultimate goal of attaining the highest level of enlightenment (Nirvana) (Ven Chanmyay Sayadaw Janakabhivamsa 1997:9 ). However, they are as equal as are others when following the paths taken that may lead them to attain Nirvana (Personal communication with Ven Ashin Manijoti, Theravada Buddhist Dhammodaya Monastery, Pietermaritzburg). the milieu of South Africa but practiced globally, the responsibility of BTS’s may broadly be grouped into two areas: 1) the provision of blood & its products to a given population based upon their estimated need; and 2) the assurance of blood and blood-product safety. While these may be considered only technical issues, they are not so clear-cut. Rather, they include conflicts of values and social-political agendas. Historically, BTSs have used discriminatory practices to exclude certain groups from blood donation. Independent of country or nation and in spite of advancements in blood screening science, the existent social-political order has influence on the policies and practices of BTSs such as the separation of groups into “high-risk” and ”low risk” blood donor categories. On the surface, such separations may appear to be straightforward scientific and prudential public health policy. However, when one considers the most common manner of HIV transmission - as occurring during intimate sexual acts which take place within society’s emphasis on private and individual rights but when such acts are considered by society to be ‘deviant ‘ - one might ask how the terms high- and low- risk are influenced by societal perceptions of the group in question. In other words, I suggest that societal (including political, religious, and economic) perceptions of a marginalised group’s private sexual acts influence public health policy; private acts have social consequences. Weighing the pros and cons of ethical arguments, this research report concludes that because of advanced blood transfusion science, it is morally justifiable to accept blood from all altruistic competent adult individuals volunteering to donate. Moreover, in this regard, it is the duty of BTS to safeguard the national blood supply by means other than excluding marginalised groups. To do otherwise is ethically unwarranted and constitutes unfair discrimination. In addition, through identifying that the act of blood donation is based on altruism or the “gift relationship,” the exclusion of marginalised groups from altruistic blood donation, serves only to further excludes them from an act, which is in essence humanitybinding. That being said, to achieve this end, all altruistic competent adults who wish to donate blood are obliged to understand the purpose, nature, and duties BTS’s have and adopt a renewed sense of social responsibility broadening our vision of the public good..

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Background: Organ transplantation is getting more important and the demand increased exponentially in the past decade. However, due to the shortage of organ supply, some people died while waiting for an organ and the other may rely on all forms of organ support to live. Hong Kong has the lowest organ donation rate among the developed world despite large-scale organ donation enhancement activities implemented for decade. Since consent from family members is mandatory, it is important to understand the reasons relatives given for consenting or refusing to donation. Objectives: (1) To investigate the change of attitudes towards organ donation in Hong Kong during 2004 to 2012. (2) To understand the difficulties of transplant coordinators encountered during counseling Methods: This is a cross-sectional survey looking at the recent change of reasons of the families of the potential donors to make decision about donation. Transplant coordinators of all 7 clusters completed questionnaires after counseling each potential donor referred during the 7 months study period. Demographic data and reasons of refusal or consent of donation were recorded and analyzed and compared with previous results. Difficulties of transplant coordinators encountered during counseling were recorded. Results: Totally 52 questionnaires were completed within 7 months. The conversion rate were similar when compared to that in 2004 (44.3% in 2004 vs 40% in 2012). The proportion of older potential donor in the refusal group is higher than that of consent group (> 60 years old 51.6% vs 38%,). The demographic data was neither statistical significantly different between consent and refusal group nor correlated with refusal of donation. From 2004 to this survey, the most common reason to refusal remained to be the traditional belief of buried intact. Both were 33%. The “expressed wish of the deceased to object donation while alive” increased from 13% in 2004 to 20% in 2012 (p=0.378), and “no consensus from family” dropped from 26% in 2004 to 11% in 2012 (p=0.083). The reason “no expression of any wish” remained static when compared to that in 2004 (15% vs 16%, p=0.982). The reason for consenting to donation changed a lot. Although the most common reason remained the “wish to help others” (94% vs 41%, p<0.0001), the second and third reason changed to “feeling good by being charitable” (21% vs 0%, p=0.0071) and “not to waste useful organs” (18% vs 3%, p=0.0455) while the fourth reason was “respect deceased’s choice”(14% vs 0%, p=0.0278). The reasons of refusal and consenting donation are explained in the context of the decision-making process. The main obstacles the transplant coordinators have encountered were knowledge gap, emotion, time pressure and family or social disharmony. Conclusion: The major reasons for consenting and refusing donation did not only change in position but also change in proportion in last decade. The importance of some reasons increased significantly and strategies to improve conversion rate should be adjusted according to the changing reasons. Education to change the traditional belief, encourage expression of donation wish, create position image of donation and the benefit of transplant are all important. / published_or_final_version / Public Health / Master / Master of Public Health

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