Assessing women's knowledge and attitudes toward cord blood banking: policy and ethical implications for Jordan.

BACKGROUND: Despite the global expansion of umbilical cord blood (CB) banking, little is known about public opinion and awareness, especially among Arab Muslim populations. CB banking raises policy questions about funding sustainability and quality standards, as well as ethical debates about profitability, informed consent, and medical justification. This study is the first of its kind in the Arab world, and Jordan has a unique, understudied, yet highly relevant setting, especially as a regional medical hub with advanced medical and health policy infrastructures. In addition, the first private and public CB banks are expected to open in 2016. STUDY DESIGN AND METHODS: The authors developed and administered, over a 5-month period, an anonymous survey to investigate public opinion and knowledge about CB banking in Jordan. The survey was administered to women in maternity outpatient clinic waiting rooms at five different hospitals. RESULTS: More than 75% of respondents indicated they knew nothing about CB banking in Jordan, and more than 50% had never heard of CB banking before. However, overall public opinion about CB storage is positive. Important factors related to public opinion were also identified, demonstrating that most women want more information on CB banking, especially from their obstetrician. CONCLUSION: This widespread lack of awareness is likely contributing to misinformation, lack of knowledge, and unfavorable perspectives toward CB donation and research. The results have important implications for the development of national and regional policies and educational campaigns on CB banking targeting both physicians and patients.

[Jehovah's Witnesses attitude towards hemocomponents and hemoderivatives]. / Testemunhas de jeová ante o uso de hemocomponentes e hemoderivados.

OBJECTIVE: To study extent of knowledge and acceptance of hemocomponents and hemoderivatives, fresh and stored, by Jehovah's Witnesses and also propose bioethical tools for any ethical and moral conflicts identified in their relationship with physicians and dentists. METHODS: A questionnaire was used to interview 150 Jehovah's Witnesses who attend "Salões do Reino" in the Distrito Federal, Brazil. The questionnaire was directed towards information on socio-demographic aspects related to the use (or not) of hemocomponents and hemoderivatives by those interviewed and also approach of healthcare professionals with patients of this belief. RESULTS: 74% believe that the use of blood causes more harm than benefits to health--refusal is essentially based on the Bible 96% do not support hemocomponents, but 76% support hemoderivatives in specific situations, showing that personal understandings do exist; 80% feel morally offended with use of stored blood and only 45% with fresh blood, confirming the religious interpretation that fresh products are in general more accepted; according to 83% of the interviewees dentists do not ask about patients' religion, whereas 71% of physicians do, showing little professional concern about this aspect. CONCLUSION: Jehovah's Witnesses are seen by their "moral outsiders" (here physicians and dentists) as the religious group that simply "does not use blood". Although, several blood treatments are nowadays permitted, it does not deprive them from a free conviction to refuse blood treatments. Their particular understandings frequently extend the list of blood prohibitions and, consequently, the number of moral conflicts, when considering that physicians and dentists usually do not ask about a patient's religion.

Testemunhas de jeová ante o uso de hemocomponentes e hemoderivados / Jehovah's Witnesses attitude towards hemocomponents and hemoderivatives

OBJETIVO: Estudar o grau de conhecimento e aceitação de hemocomponentes e hemoderivados, frescos e armazenados, pelas testemunhas de Jeová e propor ferramentas bioéticas para o enfrentamento de eventuais conflitos éticos e morais nas relações com médicos e dentistas. MÉTODOS: Aplicação de questionários a 150 testemunhas de Jeová que frequentam Salões do Reino no Distrito Federal, Brasil. Os questionários buscaram respostas a aspectos sociodemográficos relacionados à possível aceitação de hemocomponentes e hemoderivados pelos pesquisados, bem como a atitude dos profissionais de saúde ante à opção religiosa dos pacientes. RESULTADOS: Dos pesquisados: 74 por cento acreditam que usar sangue provoca mais malefícios do que benefícios à saúde (fundamentação essencialmente bíblica); 96 por cento não aceitam usar hemocomponentes, mas 76 por cento aceitam usar hemoderivados em situações específicas, demonstrando haver entendimentos particulares sobre o tema; 80 por cento se sentem moralmente ofendidos com o uso de sangue armazenado e apenas 45 por cento com sangue fresco, confirmando a interpretação religiosa de que produtos frescos são em geral mais aceitos; segundo 83 por cento dos pesquisados, seus dentistas não perguntaram a religião dos pacientes contra 71 por cento dos médicos, demonstrando pouca preocupação dos profissionais neste aspecto. CONCLUSÃO: As testemunhas de Jeová são vistas por seus "estranhos morais" (aqui, médicos e dentistas) como religiosos que simplesmente "não aceitam sangue". Todavia, diversos tratamentos sanguíneos são hoje aceitos, o que não impede, por livre convicção, a recusa no recebimento de qualquer deles. As interpretações particulares costumam ampliar o rol de proibições e de conflitos morais, já que médicos e dentistas, além de não considerar estas particularidades, também não perguntam a religião na anamnese.

OBJECTIVE: To study extent of knowledge and acceptance of hemocomponents and hemoderivatives, fresh and stored, by Jehovah's Witnesses and also propose bioethical tools for any ethical and moral conflicts identified in their relationship with physicians and dentists. METHODS: A questionnaire was used to interview 150 Jehovah's Witnesses who attend "Salões do Reino" in the Distrito Federal, Brazil. The questionnaire was directed towards information on socio-demographic aspects related to the use (or not ) of hemocomponents and hemoderivatives by those interviewed and also approach of healthcare professionals with patients of this belief. RESULTS: 74 percent believe that the use of blood causes more harm than benefits to health - refusal is essentially based on the Bible 96 percent do not support hemocomponents, but 76 percent support hemoderivatives in specific situations, showing that personal understandings do exist; 80 percent feel morally offended with use of stored blood and only 45 percent with fresh blood, confirming the religious interpretation that fresh products are in general more accepted; according to 83 percent of the interviewees dentists do not ask about patients' religion, whereas 71 percent of physicians do, showing little professional concern about this aspect. CONCLUSION: Jehovah's Witnesses are seen by their "moral outsiders" (here physicians and dentists) as the religious group that simply "does not use blood". Although, several blood treatments are nowadays permitted,. it does not deprive them from a free conviction to refuse blood treatments. Their particular understandings frequently extend the list of blood prohibitions and, consequently, the number of moral conflicts, when considering that physicians and dentists usually do not ask about a patient's religion.