Factors possibly influencing postmortal organ donation - How do consenting and refusing relatives differ?

Background: The number of relatives who refuse postmortal organ removal from a deceased family member is a relatively high 40% or so. This explorative study provides information on the motives of relatives consenting to or refusing organ donation and identifies further variables influencing the decision. Methods: Physicians talking to the next of kin of a deceased person (N=154 cases), completed a two-page questionnaire on the care offered relatives and their decision regarding organ donation. Results: Approximately two-thirds of the relatives consented to organ donation; about one-third refused it. Less than 25% of the deceased had consented to or rejected donation. In 52% of the cases the presumed wishes of the deceased person influenced the decision of family members, while about 30% of the relatives based their decision on their own position. The chief motive for consenting was altruism (68%), refusal was usually due to failure to accept the death of a loved one, or was based on the view that organ donation disfigured the deceased person. Sociodemographic parameters of the deceased person and his relatives, illness parameters, variables of the setting and time of negotiation did not correlate with the relatives' decision. A larger number of relatives present at the negotiations correlated with a larger number of refusals. Relatives spoken to by physicians who had attended an EDHEP-seminar consented more often. Conclusions: Consenting and refusing relatives differed but little. The smaller the number of relatives taking part in the negations, and the better the physician's had been trained for requesting organ donation, the more likely are relatives to give their consent.