Willing to Donate? A quantitative and thematic analysis of attitudes to deceased organ donation in different circumstances

Introduction: The UK public’s willingness to donate, knowledge of and concerns about different organ donation scenarios is not known. Methods: A 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. Results: 505 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. 96% 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 hours to decide. A small proportion of people did not support organ donation in any situation, largely for bodily integrity and religious reasons. Conclusions: In this questionnaire survey, the UK public broadly supported donation in different circumstances, including uDCD, which the majority think already happens.