Willing to Donate? A Quantitative and Thematic Analysis of Attitudes to Deceased Organ Donation in Different Circumstances.

introductionThe UK public's willingness to donate, knowledge of, and concerns about different organ donation scenarios are not known.

methodsA validated questionnaire was developed based on a literature review of the ethical issues associated with uncontrolled Donation after Circulatory Death (uDCD). Participants read three scenarios (Donation after Brain Death [DBD], controlled, and uncontrolled Donation after Circulatory Death [cDCD and uDCD]) relating to being asked about organ donation (with clear explanations of what was involved) in a randomised order. Each vignette was followed by Likert and open-ended questions. Quantitative and thematic analyses were undertaken.

resultsFive hundred and five UK participants, representative of ethnicity, gender, and age (range 18-79) were recruited via Prolific and completed the survey. Participants were likely/willing to donate in 366/504 (73%) for DBD; 336/505 (67%) for cDCD; and 368/503 (73%) for uDCD. Ninety-six per cent believed uDCD is already part of donation practice. Qualitative analysis revealed altruism as the most dominant theme. Participants did not want organs wasted, wanted to respect loved ones' wishes, and thought organ donation would provide comfort for the bereaved. For uDCD 71% agreed/strongly agreed that prioritising the chance to donate, including invasive techniques, was most important, noting the value of time for discussion; 93% thought they would need less than 4 h to decide. A small proportion of people did not support organ donation in any situation, largely for bodily integrity and religious reasons.

conclusionsIn this questionnaire survey, the UK public broadly supported donation in different circumstances, including uDCD, which the majority think already happens. PATIENT OR PUBLIC CONTRIBUTION: A Patient and Public Involvement (PPI) group of more than 30 people have been involved in a larger research project on uDCD. Two of these, both bereaved relatives of potential donors, were consulted about the design and content of the questionnaire, and provided written and oral feedback, leading to changes in wording and style; the overall research proposal, nature of questions and recruitment was supported. One of these, JC, became a core part of the research team, attending meetings with other team members and contributing to the critical analysis and write up of the research; in particular she independently read the entire dataset searching for contradictory or outlying examples and agreed that the themes reported were representative, was involved in the final drafting of the manuscript, and is a co-author.