Conversation With Nondonor Families: Refusing Organ Donation During Imminent Death

• In Event: Family Communication About Health-Related Topics

Abstract

Family refusal to consent remains one of the largest contributing factors to the dearth of organ donation in the United States. The present study uses a normative theory approach to examine family refusal at the time of imminent death. In particular, attention is given to the contextual and relational nature of the organ consent request. Semi-structured interviews were conducted with family members who had been approached by an organ procurement organization (OPO) between December 2013 and December 2015. Non-donor families described their decisions to refuse donation as (1) last acts of love (2) responses to unnecessary requests, and (3) efforts to uphold the strongly held beliefs of their loved one. Interestingly, there were contradictions in participants’ experiences; although they held positive views of the hospital and staff, they were more suspicious of the organ procurement representative. This study offers many implications for health communication scholarship. First, it demonstrates that patient families’ decisions to donate should be understood at a relational level. Second, patient families viewed end-of-life decision-making as an extension of caregiving. Third, participants articulated a tension in their experience with the OPO as both nice/professional and high-pressure/exploitative. Scripts used by medical staff to introduce the OPO to the family during imminent should be analyzed, with attention to the testing of highly tailored and relational messages.


Keywords: End-of-Life, Organ Donation, Normative Approach, Multiple Goals

Authors

• Whittney Darnell, U of Kentucky

• Kevin Real, U of Kentucky