Exploring Family Decisions to Refuse Organ Donation at Imminent Death

Whittney H. Darnell, Kevin Real, Andrew Bernard

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Communication about organ donation at the time of imminent death is a meaningful, yet less understood, area of health communication. We employed a multiple goals framework to explore family normative perceptions of organ donation and the conversational goal tensions experienced during a family member’s imminent death. Semi-structured interviews were conducted with 14 family members who refused to donate when approached by an organ procurement coordinator (OPC) upon the imminent death of a family member. Thematic analysis revealed that family members described their decisions to refuse donation as (a) last acts of love, (b) responses to unnecessary requests, and (c) consistent with the known beliefs of the patient. Participants described several goal tensions operating within the organ donation conversation itself, including (a) the management of frequent requests, (b) pressure to donate, and (c) enduring unwanted requests from the OPC. Communication goals frameworks offer practical insights for improving organ-related conversations.

Original languageEnglish
Pages (from-to)572-582
Number of pages11
JournalQualitative Health Research
Issue number4
StatePublished - Mar 1 2020

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article:This study was funded by Kentucky Organ Donor Affiliates (KODA). KODA is an organ procurement organization, KODA, who has been federally designated by the U.S. Department of Health and Human Services (HHS) and is an accredited tissue bank. KODA Tissue Operations is regulated by the Food & Drug Administration (FDA). KODA is a member of the United Network of Organ Sharing (UNOS), a government-chartered nationwide network operating the Organ Procurement and Transplantation Network (OPTN) under federal contract with the U.S. Department of Health and Human Services (HHS). The current funding was awarded through a grant ($5,000) aimed at research exploring support and decisions in end-of-life situations.

Publisher Copyright:
© The Author(s) 2019.


  • Southern United States
  • families
  • hospitals
  • intensive care unit (ICU)
  • organ donation
  • qualitative interviews
  • transplant

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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