Beyond individual willingness: family veto, legal knowledge, and the dynamics of organ donation in Türkiye.

Background/aim: The aim was to understand the factors underlying the dynamics of organ donation behavior by focusing on three different aspects. Three models were tested in this regard, namely (i) individual willingness for the donation of one's own organs, (ii) willingness to approve organ donation for close relatives, and (iii) a family veto gap. Materials and methods: A national-level adult sample from the Eurobarometer 72.3 survey (collected in 2009) conducted in Türkiye was utilized. Standard and penalized logistic regression models were employed to conduct the analyses. Results: The results show that discussing organ donation with family members and being aware of the organ donation law were associated with increased willingness to donate organs in all the study models. In addition, being a woman was associated with willingness to donate one's own organs and approval for relatives, and living in an urban area was associated with approving donation for close family members. In the last model (the family veto gap) both family discussions and knowledge of the legal regulations were associated with a higher likelihood of discrepancy between personal willingness and family authorization decisions. Conclusion: Social communication and legal awareness have a pivotal role in shaping organ donation decisions in Türkiye. Therefore, health policies that encourage social conversations and raise public awareness regarding legal regulations on organ donation may help narrow the family veto gap and strengthen societal support for organ donation. Future studies could be beneficial by including cultural and religious factors and using longitudinal approaches to better capture how donation decisions evolve over time.