title: [Family refusal of organ donation: a retrospective study in a French organ procurement center].
abstract: OBJECTIVE
  In France, organ donation refusal rates approach 32% of eligible brain deaths. Outright family refusal represents the primary barrier reason for declining organ donation. This retrospective study evaluated factors influencing this decision.
  
  
  METHODS
  A retrospective chart review at Lille Hospital, France, was conducted on brain-death patients eligible for organ donation between 2010 and 2011. Data were collected regarding patient characteristics, death conditions and reasons for refusal based upon family interview. Descriptive statistic analyses were conducted to identify circumstances associated with family refusal.
  
  
  RESULTS
  Of 227 eligible organ donors identified, 70 families (30.8%) refused organ donation. The most frequent reason for refusal was desire to keep the body's wholeness (46.3%), followed by religion (16.4%), mistrust of the medical community (13.4%), and revolt against society (6%). The most common causes of death associated with refusal were brutality and suddenness of death (44.8%), early age (23.9%), denial of death (17.9%), and the family culpability (11.9%). In 30% of cases, the family followed the deceased's wishes before his death.
  
  
  CONCLUSIONS
  Family refusal remains a significant factor associated with the approximately one third of declined eligible organ donations. This retrospective analysis suggested that the most important cause for refusal was a desire to keep the body's wholeness, and the brutality and suddenness of the potential donor's death. Additional research addressing these factors, and their underlying causes, paired with measures to improve professional training and public awareness are warranted to improve organ donation rates.
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille cedex, France. Electronic address: julien.lenobin@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Le Nobin
authors.affiliation: Service de chirurgie digestive et transplantation, hôpital Claude-Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille cedex, France. Electronic address: Francois-Rene.Pruvot@chru-lille.fr.
authors.forename: F-R
authors.initials: FR
authors.lastname: Pruvot
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille cedex, France. Electronic address: Arnauld.Villers@chru-lille.fr.
authors.forename: A
authors.initials: A
authors.lastname: Villers
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille cedex, France. Electronic address: Vincent.Flamand@chru-lille.fr.
authors.forename: V
authors.initials: V
authors.lastname: Flamand
authors.affiliation: Service d'urologie, hôpital Claude-Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille cedex, France. Electronic address: Sebastien.Bouye@chru-lille.fr.
authors.forename: S
authors.initials: S
authors.lastname: Bouye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001293:Attitude to Death; D001926:Brain Death; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005190:Family / Q000523:psychology*; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012068:Religion and Medicine; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement; D055815:Young Adult
keywords: Attitude face à la mort; Attitude to death; Brain death; Cartes de donneur; Don d’organe; Donor cards; Mort cérébrale; Organ donation; Organ harvesting; Prélèvement d’organe; Refus de participer; Refusal to participate; Religion