公民对脑死亡标准立法态度的现状调查

李小杉; 缪俊艳; 胡迪; 钱共匋

doi:10.3969/j.issn.1674-7445.2020.01.014

公民对脑死亡标准立法态度的现状调查

doi: 10.3969/j.issn.1674-7445.2020.01.014

214023 无锡，南京医科大学附属无锡人民医院医务处器官捐献与移植管理办公室（李小杉、钱共匋）；南通大学公共卫生学院（缪俊艳、胡迪）

基金项目:

中国人体器官捐献专项研究课题 CODMP2017016

详细信息

作者简介:
李小杉，男，1987年生，博士，助理研究员，研究方向为器官捐献与器官移植质量管理，Email: sclxs87@163.com

通讯作者:
钱共匋，男，1983年生，硕士，助理研究员，研究方向为器官捐献与器官移植质量管理，Email: qiangongtao@sina.com

中图分类号: R617, D901
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出版历程
- 收稿日期: 2019-10-09
- 网络出版日期: 2021-01-19
- 刊出日期: 2020-01-15

Investigation of current status of citizen's attitude to legislation of brain death criteria

Department of Medical Affairs, Organ Donation and Transplant Management Office, Wuxi People's Hospital, Affiliated to Nanjing Medical University, Wuxi 214023, China

More Information

Corresponding author: Qian Gongtao, Email: qiangongtao@sina.com

摘要

摘要: 目的调查公民对脑死亡的认知及脑死亡标准立法的态度。方法采用方便抽样法选取1 500名门诊就诊患者或陪同人员为研究对象，进行问卷调查。采用Epidata 3.02软件双人双机录入问卷，采用单因素和多因素Logistic回归模型分析影响调查对象支持脑死亡立法的因素。结果 1 433名有效调查对象中，84.65%(1 213/1 433)听说过脑死亡，其中24.32% (295/1 213)认为脑死亡是合理的死亡判定标准，支持、反对脑死亡立法的比例分别为49.79% (604/1 213)和17.31 %(210/1 213)。男性[比值比(OR)=1.3，95%可信区间(CI)1.0~1.6]、文化程度大专或本科以上学历者(OR=1.5，95%CI 1.1~1.9)、亲友从事过器官捐献工作者(OR=3.3，95%CI 1.1~10.3)、参加过器官捐献公益活动者(OR=3.1，95%CI 1.6~6.0)和认为脑死亡是合理的死亡判定标准者(OR=2.0，95%CI 1.5~2.6)更倾向于支持脑死亡立法，是影响脑死亡立法的独立影响因素(均为P < 0.05)。结论公民对脑死亡的认知程度及对脑死亡标准立法的支持程度均较低，应加强脑死亡的相关宣传，增强立法民意基础。
- 脑死亡 /
- 器官捐献 /
- 器官移植 /
- 脑死亡标准 /
- 立法 /
- 公民逝世后器官捐献 /
- 脑-心双死亡器官捐献 /
- 心脏死亡器官捐献
Abstract: Objective To investigate the citizen's attitude towards the cognition of brain death and the legislation of brain death criteria. Methods A questionnaire survey was performed in 1 500 outpatients or accompanying personnel by the convenient sampling method. The questionnaire data were independently recorded by two professionals using the Epidata 3.02 software. The factors influencing the citizen's support of the legislation of brain death were analyzed by univariate and multivariate Logistic regression models. Results Among 1 433 eligible respondents, 84.65% (1 213/1 433) of them knew brain death, and 24.32% (295/1 213) considered brain death as a reasonable criterion for death. The proportion of respondents who supported and opposed the legislation of brain death was 49.79% (604/1 213) and 17.31% (210/1 213).Male [odds ratio (OR)=1.3, 95% confidence interval (CI) 1.0-1.6], those with junior college degree or above at educational level (OR=1.5, 95%CI 1.1-1.9), those whose relatives and friends were engaged in organ donation (OR=3.3, 95%CI 1.1-10.3), those who participated in public welfare activities of organ donation (OR=3.1, 95%CI 1.6-6.0) and those who regarded brain death as a reasonable criterion for death (OR=2.0, 95%CI 1.5-2.6) were more inclined to support the legislation of brain death, which were the independent influencing factors of the legislation of brain death (all P < 0.05). Conclusions Citizens have relatively low cognition and support of the legislation of brain death criteria. Relevant propaganda on brain death should be widely carried out to strengthen the citizen basis for the legislation.
- Brain death /
- Organ donation /
- Organ transplantation /
- Brain death criterion /
- Legislation /
- Donation after citizen's death /
- Donation after brain death followed by cardiac death /
- Donation after cardiac death

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表 1 在听说过脑死亡的调查对象中影响支持脑死亡立法因素的单因素分析

Table 1. The univariate analysis of the influence factors of supporting brain death legislation amongsubjects who heard of brain death [n (%)]

变量	n	听说过脑死亡人数 [n (%)]	脑死亡立法支持率 [n (%)]	P值	OR(95%CI)
年龄	1 213
< 30岁		643(53.01)	322(50.08)	0.834	1.0 (0.8~1.3)
≥30岁		570(46.99)	282(49.47)		1.0
性别	1 213
男		650(53.59)	345(53.08)	0.014	1.3 (1.1~1.7)
女		563(46.41)	259(46.00)		1.0
民族	1 213
汉族		1 196(98.60)	596(49.83)	0.820	1.1 (0.4~2.9)
少数民族		17(1.4)	8(47.06)		1.0
婚姻	1 213
未婚		517(42.62)	263(50.87)	0.411	1.4 (0.6~3.0)
已婚		668(55.07)	329(49.25)	0.508	1.3 (0.6~2.8)
其他		28(2.31)	12(42.86)		1.0
独生子女	1 213
是		623(51.36)	319(51.20)	0.313	1.1 (0.9~1.4)
否		590(48.64)	285(48.31)		1.0
文化程度	1 213
高中或中专以下		398(32.81)	170(42.71)	0.001	1.0
大专或本科以上		815(67.19)	434(53.25)		1.5 (1.2~1.9)
宗教信仰	1 213
有		195(16.08)	97(49.74)	0.988	1.0
否		1 018(83.92)	507(49.80)		1.0 (0.7~1.4)
月收入	1 213
< 5 000元		486(40.07)	226(46.50)	0.061	1.0
≥5 000元		727(59.93)	378(51.99)		1.2 (1.0~1.6)
家庭所在地	1 213
城镇		749(61.75)	384(51.27)	0.192	1.2 (0.9~1.5)
农村		464(38.25)	220(47.41)		1.0
亲友从事过器官捐献工作	1 213
是		20(1.65)	16(80.00)	0.012	4.1 (1.4~12.4)
否		1 193(98.35)	588(49.29)		1.0
亲友捐献过器官	1 213
是		23(1.90)	13(56.52)	0.516	1.3 (0.6~3.0)
否		1 190(98.10)	591(49.66)		1.0
亲人接受过器官移植	1 213
是		57(4.70)	28(49.12)	0.917	1.0
否		1 156(95.30)	576(49.83)		1.0 (0.6~1.8)
参加过器官捐献公益活动	1 213
是		54(4.45)	41(75.93)	< 0.001	3.3 (1.8~6.3)
否		1 159(95.55)	563(48.58)		1.0
认为脑死亡是合理的死亡判定标准	1 213
是		295(24.32)	185(62.71)	< 0.001	2.0 (1.5~2.6)
否		918(75.68)	419(45.64)		1.0

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表 2 在听说过脑死亡的调查对象中影响支持脑死亡立法因素的多因素Logistic回归分析

Table 2. The multivariate Logistic regression analysis of the influence factors of supporting brain death legislation among subjects who heard of brain death

变量	β值	S_x值	Waldχ²值	P值	OR (95%CI)
男性	0.25	0.12	4.57	0.033	1.3(1.0~1.6)
文化程度大专或本科以上	0.37	0.13	8.82	0.003	1.5(1.1~1.9)
亲友从事过器官捐献工作	1.20	0.58	4.32	0.038	3.3(1.1~10.3)
参加过器官捐献公益活动	1.14	0.33	11.96	0.001	3.1(1.6~6.0)
认为脑死亡是合理的死亡判定标准	0.67	0.14	23.23	< 0.001	2.0(1.5~2.6)

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参考文献(16)

[1]	中国人体器官捐献管理中心.捐献完成登记捐献志愿登记[EB/OL].[2019-05-30]. http://www.rcsccod.cn/.
[2]	黄洁夫, 叶啟发.建立中国模式的公民器官捐献体系, 为人民群众提供高质量的器官移植医疗服务[J].武汉大学学报(医学版), 2017, 38(6):861-865. DOI: 10.14188/j.1671-8852.2017.06.001. HUANG JF, YE QF. Establishing the Chinese model of organ donation and transplant system to provide high level ethical transplant service for the Chinese people[J]. Med J Wuhan Univ, 2017, 38(6):861-865. DOI: 10.14188/j.1671-8852.2017.06.001.
[3]	中华医学会器官移植学分会.中国公民逝世后器官捐献流程和规范(2019版)[J].器官移植, 2019, 10(2):122-127. DOI: 10.3969/j.issn.1674-7445.2019.02.003. Branch of Organ Transplantation of Chinese Medical Association. Process and specification of Chinese donation after citizen's death (2019 edition)[J]. Organ Transplant, 2019, 10(2):122-127. DOI: 10.3969/j.issn.1674-7445.2019.02.003.
[4]	屈伸.浅谈脑死亡立法的必要性及立法建议[J].法制与社会, 2016, (25):269-270.DOI:10.19387/j.cnki.1009- 0592.2016.09.128. QU S. The necessity and suggestions of legislation on brain death[J]. Leg System Soc, 2016, (25):269-270. DOI: 10.19387/j.cnki.1009-0592.2016.09.128.
[5]	中国人体器官捐献管理中心.2018两会观察: 遗体和人体器官捐献议题再获关注[EB/OL].[2018-03-19]. https://www.codac.org.cn/news/newsinformation/20180319/696800.htm.
[6]	蔡昱.对我国脑死亡的立法形式、立法内容及判断程序的建议[J].中国医学伦理学, 2019, 32(2):187-194. DOI: 10.12026/j.issn.1001-8565.2019.02.11. CAI Y. Suggestions on the legislative form, legislative content and judgment procedure of brain death in China[J]. Chin Med Ethics, 2019, 32(2):187-194. DOI: 10.12026/j.issn.1001-8565.2019.02.11.
[7]	王霖婧, 郏将希, 王璐璐, 等.不同人群对脑死亡认识及立法可行性调查报告[J].医学信息, 2019, 32(10):133-135. DOI: 10.3969/j.issn.1006-1959.2019.10.044. WANG LJ, JIA JX, WANG LL, et al. Report on the understanding of brain death and legislative feasibility of different populations[J]. Med Inform, 2019, 32(10): 133-135. DOI: 10.3969/j.issn.1006-1959.2019.10.044.
[8]	ZHANG H, ZHENG J, LIU W, et al. Investigation and strategic analysis of public willingness and attitudes toward organ donation in east China[J]. Transplant Proc, 2015, 47(8):2419-2424. DOI: 10.1016/j.transproceed.2015.09.011.
[9]	HU D, HUANG H. Knowledge, attitudes, and willingness toward organ donation among health professionals in China[J]. Transplantation, 2015, 99(7):1379-1385. DOI: 10.1097/TP.0000000000000798.
[10]	张立民, 张玉平, 郭亚雄, 等.临床医学本科生对脑死亡认识的调查与分析[J].河北北方学院学报(自然科学版), 2017, 33(10):58-60.DOI:10.3969/j.issn.1673-1492. 2017.10.019. ZHANG LM, ZHANG YP, GUO YX, et al. Investigation and analysis of cognition for brain death in undergraduates majoring in clinical medicine[J]. J Hebei North Univ (Nat Sci Edition), 2017, 33(10):58-60. DOI: 10.3969/j.issn.1673-1492.2017.10.019.
[11]	杨春华, 陈雪霞, 陈丽, 等.重症监护病房脑死亡后器官捐献认知调查[J].中华医学杂志, 2014, 94(20):1570-1572. DOI: 10.3760/cma.j.issn.0376-2491.2014.20.013. YANG CH, CHEN XX, CHEN L, et al. Intensive care unit survey of cognition status of donation after brain death[J]. Natl Med J China, 2014, 94(20):1570-1572. DOI: 10.3760/cma.j.issn.0376-2491.2014.20.013.
[12]	李长兵, 许晓娟.论我国刑法中的死亡标准[J].江西社会科学, 2012, (8):132-136. DOI: 10.3969/j.issn.1004-518X.2012.08.026. LI CB, XU XJ. Discussion on the standard of death in China criminal law[J]. Jiangxi Soc Sci, 2012, (8):132-136. DOI: 10.3969/j.issn.1004-518X.2012.08.026.
[13]	宋儒亮, 崔小花, 高霑, 等.脑死亡与器官移植立法课堂调查问卷分析[J].中国循证医学杂志, 2009, 9(12):1296-1301.DOI: 10.3969/j.issn.1672-2531.2009.12.014. SONG RL, CUI XH, GAO Z, et al. Classroom questionnaire of brain death and organ transplant legislation[J]. Chin J Evid Based Med, 2009, 9(12):1296-1301. DOI: 10.3969/j.issn.1672-2531.2009.12.014.
[14]	新浪网.器官捐献协调员, 这个岗位你听过吗?全国2200多名[EB/OL].[2019-05-01]. https://k.sina.cn/article_2900118455_macdc4bb703300g53x.html?vt=4&pos=91&from=news&subch=onews.
[15]	张平, 贺光社, 王慧鹏, 等.从2起案例看脑死亡立法的现实需求[J].中国医学伦理学, 2016, 29(3):452-454. DOI: 10.12026/j.issn.1001-8565.2016.03.26. ZHANG P, HE GS, WANG HP, et al. The realistic requirement of brain death legislation from 2 cases[J]. Chin Med Ethics, 2016, 29(3):452-454. DOI: 10.12026/j.issn.1001-8565.2016.03.26.
[16]	杨颖, 黄海, 邱鸿钟.中国传统文化和观念对器官捐献意愿的影响分析[J].中国组织工程研究, 2014, 18(5):803-808.DOI: 10.3969/j.issn.2095-4344.2014.05.025. YANG Y, HUANG H, QIU HZ. Influence of traditional Chinese culture and ideas on organ donation[J]. Chin J Tissue Eng Res, 2014, 18(5):803-808. DOI: 10.3969/j.issn.2095-4344.2014.05.025.