The stability of family decisions to consent or refuse organ donation: would you do it again?

OBJECTIVE: Past organ donation research has studied attitudes toward donation, predictors of signing donor cards, and distinguishing characteristics of donors vs. nondonors. The current study is the first to examine predictors of family members' satisfaction with the decision to consent or refuse donation of a dying loved one's organs or tissue.

METHOD: This study surveyed 225 family members who had been approached to donate the organs or tissue of a dying loved one. Participants were surveyed about demographic characteristics, medical/hospital factors, previous knowledge of transplantation, the request process, religion, and characteristics of the deceased and of the recipient. Discriminant analyses were conducted to characterise four specific groups: a) donors who would donate again; b) donors who would not donate again; c) nondonors who would now donate; and d) nondonors who still would not donate.

RESULTS: Three significant discriminant functions emerged discriminating donors from nondonors, those who were satisfied with their decision from those who were not, and people who would now donate from those who would not. Donation was predicated by formal education, being married, volunteerism, signing donor cards, and having personal conversations about donation. Subsequent satisfaction was predicted by comfort and confidence during the decision-making process, familiarity with medical center, and understanding of brain death. A willingness to now donate was predicted by personal discussions about donation.

CONCLUSIONS: People should be encouraged not only to sign donor cards, but to have discussions with family about wishes. Individuals should be encouraged to seek the help of family and friends during the decision, and be aware of the need of social support from family and friends during and after the decision.