title: Understanding Australian families' organ donation decisions.
abstract: Numbers of deceased organ donors in Australia have increased, but rates of consent to donation remain at around 60%. Increasing family consent is a key target for the Australian Organ and Tissue Authority. Reasons for donation decisions have been reported in the international literature, but little is known of reasons for Australian families' decisions. Potential organ donors in four Melbourne hospitals were identified and 49 participants from 40 families (23 consenting and 17 non-consenting) were interviewed to understand reasons for consent decisions. Themes for consent to organ donation included that: donation was consistent with the deceased's explicit wishes or known values, the desire to help others or self-including themes of altruism, pragmatism, preventing others from being in the same position, consolation received from donation and aspects of the donation conversation and care that led families to believe donation was right for them. Themes for non-consent included: lack of knowledge of wishes; social, cultural and religious beliefs; factors related to the donation process and family exhaustion; and conversation factors where negative events influenced decisions. While reasons for consent were similar to those described in international literature, reasons for non-consent differed in that there was little emphasis on lack of trust of the medical profession, concerns regarding level of care provided to the potential donor, preserving the deceased's body, fears of body invasion or organ allocation fairness.
authors.affiliation: Emergency Department, St Vincent's Hospital, Melbourne, Victoria.
authors.forename: S L
authors.initials: SL
authors.lastname: Neate
authors.affiliation: Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria.
authors.forename: C H
authors.initials: CH
authors.lastname: Marck
authors.affiliation: DonateLife Victoria, Melbourne, Victoria.
authors.forename: M
authors.initials: M
authors.lastname: Skinner
authors.affiliation: Organ and Tissue Authority, Canberra, Australian Capital Territory.
authors.forename: B
authors.initials: B
authors.lastname: Dwyer
authors.affiliation: Intensive Care Unit, Western Hospital, Melbourne, Victoria.
authors.forename: F
authors.initials: F
authors.lastname: McGain
authors.affiliation: Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria.
authors.forename: T J
authors.initials: TJ
authors.lastname: Weiland
authors.affiliation: Intensive Care Unit, St Vincent's Hospital, Melbourne, Victoria.
authors.forename: B B
authors.initials: BB
authors.lastname: Hickey
authors.affiliation: Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria.
authors.forename: G A
authors.initials: GA
authors.lastname: Jelinek
mesh_terms: D000533:Altruism; D001293:Attitude to Death; D001315:Australia; D003657:Decision Making / Q000502:physiology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D014019:Tissue Donors / Q000523:psychology*; D009927:Tissue and Organ Procurement
keywords: altruism; human rights; tissue and organ procurement; tissue donors