Practical implications

Since respondents disclosed having a considerable lack of knowledge of both the basic facts about organ donation as well as the workup of the manipulation scandal, connecting these two topics within the information campaign seems to be a proposal that has the potential to work better than previous efforts which deliberately left out the latter. Obviously,

transparency and honesty are vital, especially for an intimate subject such as organ donation and participants named these criteria as important aspects they require for their involvement with the topic. The scandal and its improvement consequences are a topic that cannot be ignored as the German public clearly has a demand for information about it. Of course, an argument against that proposal might be that it brings back this bad event into the collective memory but since the level of trust is so unsatisfying anyway, the risk seems worth taking. Even more so, the almost 4 years that have gone by since the scandal and the introduction of the improvement measures might bear a potential benefit. It offers the possibility to not only present what has been done but also which positive effects and changes they already caused and promise to cause in the future. Since the German public has a strong demand to see positive change that could be a successful way to meet it.

A potentially influential aspect for the public’s trust could be that the head of the transplantation center in Göttingen was set free because his actions weren’t legally punishable

40

in the past (Süddeutsche Zeitung, 2015). That robs the advantage of informing the public about the legal consequences for the manipulators because even though some doctors lost their license, this case could still be the dominant one in the public eye – and a negative one at that – risking the premise that the system is considerably safer in the present and future. Still, showing that legal penalties have been introduced seems to be an appropriate way to illustrate that the measures did not just stop at the procedural control level.

It should also be noted that while physicians and the government took the spotlight in the participants’ view on who is responsible and that the government and insurance

companies were the most sought-after sources for information on post-scandal consequences, other parties involved in the organ donation system can feel like they have no role in the upcoming steps. Eurotransplant, the DSO and the transplantation centers should take these results just as seriously as those being in focus. As Benoit (1997) states for his Image Restoration Theory, not just those who are factually responsible are necessarily viewed as such by the relevant audience. In the case that future information campaigns explain the system’s detailed structure and history with every party in it to the public, attention on them will most likely increase anyway. Investing in the furthering of knowledge from the start might be of strategic benefit then. An interconnection would also signalize a coherent public image to society, which is an important aspect given the confusion many citizens feel when asking themselves who to turn to. This could be supported by initiating public conventions with expert speakers representing the different organizations, letting them appear in TV formats and publishing interview articles in high-circulation newspapers.

Another issue that could be problematic for the designers of such an information initiative is that physicians showed decreasing willingness to address the topic in

conversations with their patients due to frustration and distrust towards the system, as shown by Söffker et. al. (2014) and Grammenos et. al. (2014). It is another challenge for the

government to win the medical personnel over for this information offensive, otherwise a fraction of the citizens is harder to reach. As McGlade and Pierscionek (2013) showed, medical personnel responded positively to more information about organ donation, which is why approaching German physicians and personnel could be of value. If they became more open to the topic again and presented it to their patients in a more positive manner, it could lead to greater acceptance among patients. As this study shows, physicians are a sought-after and highly trusted source when people think about organ donation. The German medical association could initiate conventions and ask its members to attend presentations where the importance of promoting the topic is highlighted. In addition to that, written information

41

materials such as brochures directed at physicians in which their role and suggested talking points are discussed could be a more cost-effective way.

In summary, the following suggestions are derived from the results of this study:

 Government-led information campaign that also involves all other mentioned parties. Their involvement demonstrates the system’s coherence (“speaking with one voice”) and they benefit from sharpening their profile in the public eye (e.g. DSO), adding to the overall transparency that is in such high demand.

 High emphasis on content. Increasing transparency and completeness by inclusion of the organ scandal events and the implementation of post-scandal consequences, highlighting positive improvement developments to gain public trust in current situation.

 Revision of existing information about the basics of organ donation; focus on clear step-by-step explanations for criteria, procedure and network overview. Information brochure sent to every household, organizing information evenings for interested citizens, offering websites and hotlines to answer questions

 Intensifying the media presence by cooperating more tightly with TV, journalistic outlets and websites. Advertisement, expert discussions in fitting TV formats, documentaries (both print and TV), storytelling about successes and changes made

 Encouraging physicians to increase efforts in addressing and promoting organ

donation towards their patients. Providing them with information materials to hand out to patients and to display in the waiting rooms.

42