Chloe Laetitia Lim, 15

School: Raffles Girls’ School (Secondary)

Topic: Can social media make a positive impact on organ donation?

Award: First Place, Senior Category, 2023

A Double-Edged Sword: Nurturing Organ Donation Awareness on Social Media While Tackling Ethical Predicaments

Introduction

Social media is ubiquitous in the 21st century first-world, permeating every aspect of our lives and shaping our interactions and behaviours - even our perception of reality. With its influence transcending geographical and linguistic boundaries, it has been a key instrument behind several social movements such as the Black Lives Matter movement, advocating for fair treatment of African-American individuals, as well as the MeToo movement, which brought justice to sexual assault survivors through demanding accountability for perpetrators. Social Media, while presenting its own ethical predicaments, can be an effective tool for social activism due to its ability to empower the common man to create change. It encourages more donations at the cost of ethical healthcare, and can thus create both positive and negative impacts on organ donation.

Driving Change

One of these aforementioned changes: the waves of positive messaging on the organ donation front encouraging more and more people to donate their organs. A study by John Hopkins Medicine researchers found a whopping 21-fold increase in the number of people who registered themselves as organ donors in a single day when networking giant Facebook allowed users to share their organ donor status. A more recent 2019 review which compiled and analysed present research seconds this finding. It concluded that exposing individuals to social media messages about organ donation can significantly increase registration rates.

Another key finding of the study was that leveraging the power of social networks allowed targeted messaging and active public participation. Hence, social media campaigns could effectively raise awareness and dispel adverse myths, thereby increasing organ donor registration rates.

Breaking Boundaries: Social Media’s Global Accessibility

Social media enables a wide audience to be reached in real time due to its global accessibility. It overcomes the geographical boundaries that have long hindered communication between those physically apart, allowing information to reach individuals across regions, thereby enabling information dissemination to a large and diverse audience.

With global internet access increasing, social media has become widely accessible to people from all walks of life, allowing anyone with a device and connection to now access online resources. This has enabled information about organ donation to be shared on a never seen before scale, driving up donation volumes exponentially.

However, the sheer magnitude of social media is just one factor of its ability to generate positive change: being internet technology, it is also able to provide users real-time updates, enabling timely information dissemination. Users and organisations can publicise organ donation related news with the click of the button, which others can access in mere seconds. This immediate circulation of information ensures that people remain informed about current affairs in organ donation.

Social media can thus encourage organ donation as it facilitates the rapid and widespread dissemination of related information, which can help improve knowledge and dispel misconceptions surrounding organ donation.

The Personal Touch and The Viral Potential

While social media reaches users across diverse demographic groups, cutting across linguistic and geographical barriers, it does not stop at simply addressing the world - it also targets and tailors messages to resonate with specific communities, thereby overcoming the aforementioned barriers.

As social media provides opportunities for active public engagement, individuals can share related personal testimonials, express their support for organ donation, and actively participate in campaigns. This engagement can raise awareness, dispel myths, and foster an overall positive attitude towards organ donation.

This effect is amplified through social media’s sharing capabilities, which enables content to go viral rapidly as users share information with their networks, expounding their reach and engagement. When information is shared by influential individuals or peer networks, others are further inspired to engage with the cause and share it too. This snowball effect leads to content going viral on social media, exponentially increasing its reach.

Social media thus has the potential to create viral campaigns that attract significant attention. Personalised yet shareable organ donation content can quickly spread across social networks, increasing awareness and potentially influencing individuals to register as donors.

However, while the visible positive impacts that social media has had on organ donation cannot be denied, to say that its impacts are solely positive simply due to the discernible increase in the number of organ donations would be far too myopic. As much as social media has helped mobilise people, it also presents a host of ethical issues that we must be prepared to deal with, especially in the slippery world of organ donation.

Influence: A Mixed Blessing

A key concern with social media encouraging organ donation is social media bias - the very quality that lends social media its influential power. Social media primarily relies on pathos to influence. When users make the decision to become an organ donor, it is their evoked sympathy toward patients which helms their decision making. However, when such a critical decision leverages on the pity of viewers, engaging their emotional opinions and decisions rather than their logical opinion, it brings into question the ethics of such advertising. Afterall, are donors given the opportunity to make a truly unbiased, objective decision, when they are being bombarded with positive messaging?

Echo chambers further expound this issue: users who often interact with content directed positively toward organ donation would be perceived to be supportive of it by the algorithm, leading to even more related content to be promoted to the user. This however, significantly reduces their chances of seeing contrasting opinions. When users are only given one sided information and opinion, their own opinion is confirmed, and their ability to make an objective decision is markedly curbed. This is especially so if a user’s social networks are all supportive of organ donation: they may be pressured and “incited” to donate, rather than being allowed to make the decision on their own. On the flip side, a user who is unsupportive of organ donation may conversely only ever be presented with negative messaging, hindering them from ever changing their opinion.

Life at a Price

Then there is the issue of organ trafficking. The black market - especially the illegitimate trade of body parts - is nothing unheard of, but it has been further enabled by social media. Organ buyers and sellers can now be easily linked via social media, a worrying trend as organ donation is often regarded altruistically. The decision to sell an organ, however, might be coloured by coercion, blackmail, or financial need, calling into question the ethics of free decision making by donors. For instance, a desperate and well-off family might coerce and pay an individual for an organ, knowing that the financially desperate donor would have little choice but to accept such an arrangement.

This worry is not unfounded. When a team of researchers at the Loyola University Medical Center sampled facebook pages involving organ donations, they found that 3% of the pages had received offers to sell kidneys, mostly from people in Third World countries. While social media companies largely prohibit such activities, there are still accounts left unflagged by the algorithm. This is evident in a report by Channel News Asia, following the story of Carlos, a Filipino who despite being fearful, decided to sell his kidney via Facebook to finance the birth of his baby girl.

Its effects do not stop there. The sale of human organs - especially between third-world and first-world countries - could establish a free market system that unjustly allocates human organs to the highest bidder, widening health care disparities.

Drowning in Deception

In the same research as above, it was found that only 5% of pages mentioned the risks of kidney donation - such as possible internal bleeding and/or infection as a result of the surgery. Furthermore, only 11% mentioned kidney donation’s associated costs. This worrying trend of concealing information in an effort to encourage more donations could lead to unsuspecting donors being shocked by exorbitant costs, which they may not be able to pay off, as well as permanent ramifications on their health.

The dark underbelly of social media’s advertising is the inadvertent circulation of fake news and information omission, which could lead to donors - in their search for information - being misinformed and making judgements that might end up harming themselves.

Conclusion

Hence, it could be argued that another change that social media has created in the organ donation community is the ethics of organ donation: its fundamental ethical principles of utility, justice, and respect for persons, which currently create a framework for the equitable allocation of scarce organs for transplantation have now been eroded. Yet, all things considered - such as the influx of donors due to social media - one should not disregard using social media to gain or share organ donation content altogether. Rather, to quote Alexander Chang, nephrology fellow at Loyola University Chicago Stritch School of Medicine, “using social media may be an effective way to inform friends and family of the need for a kidney, and then a much more formal discussion can be initiated.” Overall, while social media can create a positive impact on organ donation, its possible negative implications should not be dismissed.

References

1. https://www.hopkinsmedicine.org/news/media/releases/the_facebook_effect_social_media_dramatically_boosts organdonor_registration#:~:text=A%20social%20media%20push%20boosted,shortage%20in%20the%20United%20States.

2. https://onlinelibrary.wiley.com/doi/10.1111/ajt.15345

3. https://www.scientificamerican.com/article/facebook-organ-donation/

4. https://www.channelnewsasia.com/asia/kidney-organs-for-sale-on-facebook-in-philippines-857526

Disclaimer: Please note that the views and opinions expressed in the essays for the Live On Festival 2023 are those of the participants and are not endorsed by the National Organ Transplant Unit (Ministry of Health). To learn more about organ donation and organ transplantation in Singapore, please visit www.liveon.gov.sg