Campaign targets TV's skewed view of organ donation

About 20 million Americans tuned in for an October 2005 episode of ABC's medical drama "Grey's Anatomy" in which a woman is prematurely declared brain dead. When an intern discovers she is still responsive to stimuli, a literal tug-of-war over the patient breaks out, and the transplant team chides the hospital staff for its resistance.

Such inaccurate and negative portrayals of organ donation and transplantation are surprisingly common on TV and feed the public's fears about the process, according to new research.

Now, a coalition of more than three dozen organ procurement and transplant organizations, called Donate Life Hollywood, is urging TV producers and writers to think twice before taking creative license in telling stories that could indirectly hurt the more than 96,000 patients waiting for organ transplants.

The campaign targets a "top 10" list of inaccurate storylines that recur frequently on TV, such as the notion that Americans are killed for their organs or that a black market for organs exists in the U.S. Other common lapses include misrepresenting brain death and how organs are allocated.

"If there were a storyline about someone who contracted HIV from a toilet seat, there would be an uproar," said Tenaya Wallace, director of the Donate Life Hollywood campaign and a spokeswoman for the OneLegacy Transplant Donor Network in Southern California. "By presenting that inaccuracy, you would be creating a public health crisis. It's the same thing with organ donation."

Wallace acknowledges that the U.S. donation system is not perfect but said error-ridden Hollywood portrayals weaken patients' trust in the process. The campaign will monitor Hollywood storylines and ask member organizations to write producers and writers in response to misinformation. The ultimate goal, Wallace said, is to meet regularly with entertainment executives to explain the importance of accurately portraying the organ system and to offer expert resources to producers and writers.

The campaign already has targeted a new TNT show, "Heartland," that centers on a transplant surgeon and his ex-wife, an organ procurement coordinator. While the drama steers clear of Donate Life Hollywood's taboo top 10, there are "fundamental flaws in how the donation and transplant process is presented," Wallace wrote in a letter to executive producer David Hollander.

For example, the procurement coordinator works for the transplant center -- a conflict of interest that is avoided in real life. Also, Wallace said, the show inaccurately portrays how the families of potential donors are approached. Hollander did not respond to interview requests by deadline.

People believe what's on TV

Recent research on the media's impact on viewers sparked Donate Life Hollywood into being. An August Health Communication study found that 80 fictional TV shows aired on the broadcast networks in 2004 and 2005 touched on organ donation and transplantation. Not one of the shows presented the process accurately and positively, lead author Susan E. Morgan, PhD, concluded in her paper.

On top of that, an October 2005 Clinical Transplantation study Dr. Morgan authored found that when family members discussed organ donation with each other they often referred to Hollywood storylines to explain their fears.

Because most people cannot test the accuracy of fictional portrayals against personal experience with organ donation and transplantation, the "power of narrative" can win out, said Dr. Morgan, associate professor of communication at Purdue University.

"We're hard-wired for stories," she said. "Thousands of years ago, before TV, people sat around the fire and told stories. Our television has become our hearth. We all live with a box that tells us stories all day long. Those stories become very powerful in influencing our thinking, especially when we don't have a competing source of information."

A 2005 Gallup survey of 2,000 Americans found that 43% listed TV and movies as an "important source of information" about organ donation. Inaccurate Hollywood portrayals can help explain why 95% of people told Gallup they strongly support organ donation, but less than half agree to donate the organs of a loved one when the time comes, Dr. Morgan said.

Neither the American Society of Transplantation nor the American Society of Transplant Surgeons is a member of the new campaign, but AST Organ Donation Committee Chair Henkie P. Tan, MD, PhD, said donors and recipients often repeat urban legends and Hollywood fiction as truth.

"Any myth that's out there should be removed, because we need these organs to save lives. We need to give the facts instead," Dr. Tan said.

The campaign is not the first effort designed to get Hollywood to change its tune on organ donation and transplantation. The Health Resources and Services Administration's Division of Transplantation has given $150,000 over the last two years to Hollywood, Health & Society. The project at the University of Southern California's Annenberg Norman Lear Center aims to give entertainment industry professionals timely information to boost medical storyline accuracy.

But such efforts can be a mixed bag. The group, budgeted for another $100,000 from HRSA in fiscal year 2008, worked with "Numb3rs" writer J. David Harden to include a positive message about signing up to be an organ donor in the concluding minutes of a January 2006 episode. But the bulk of the CBS police procedural was devoted to a supposed black market for organs in Los Angeles, a practice Harden knew existed in Brazil and India but was "highly unrealistic" for the U.S.

"We brought the reality of a global trade in black market organs to Los Angeles," Harden said, defending his creative decision. "Our implausibility was geographic, not medical."

A spokesman for the Writers Guild of America, West, declined to comment on the Donate Life Hollywood campaign. The AMA has extensive policy on organ donation, but none specifically on how it is portrayed on TV or in the movies.