Determinants of family consent to organ donation in brain-dead patients: a qualitative study

Examining the determinants of family consent to organ donation is important to provide comprehensive information to policymakers and health planners, enabling them to enhance organ donation rates. Therefore, this study aimed to identify these determinants among families of brain-dead patients in Iran. This qualitative study was conducted using the conventional content analysis method among individuals who had experience with organ donation within their families, as well as key informants who were in contact with these families. Twenty-eight participants were identified through purposive and snowball sampling, and data were collected through semi-structured interviews until saturation was reached. For data analysis, the approach of Graneheim and Lundman was used, and Guba and Lincoln’s criteria were also adhered to for the rigor of the research. From the coding of the interviews, 4 categories, 13 subcategories, and 275 initial codes were obtained. These include cognitive and emotional maturity (awareness saturation, previous experiences of the suffering of patients in need of organ transplants, decision validation, altruistic sense, and respecting the patient’s wishes and desires), spiritual maturity (spiritual orientation and desacralization of the physical body), social maturity (social responsibility, social incentives, family consensus in decision-making, and social class), and effective communication between the patient’s family and the healthcare system (professional behavior of healthcare staff and trust in the organ donation process). The findings of this study showed that family consent to organ donation is influenced by various factors; therefore, increasing the rate of organ donation requires intervention at individual, spiritual, social, and healthcare levels.