Perceived consequences of communicating organ donation wishes: An analysis of beliefs about defending one's decision

Family communication about organ donation is vital but rare. This research sought to understand a key barrier to communication among young adults: potentially having to defend one's decision to parents. In Study 1, 28 undergraduates considered the advantages and disadvantages of defending a decision about donation to their parents. Fifteen beliefs addressing parental acceptance, knowledge, related discussions (mortality, religion), appearing ignorant, and decision uncertainty, justification, and regret emerged. In Study 2, 209 students evaluated each belief, reported disclosure intentions, and confronted a behavioral option to disclose donation decisions to parents. Students were less likely to disclose if they believed they might change their mind (OR=0.41; 95% CI 0.24-0.71) or think they made the wrong choice (OR=0.33; 95% CI 0.18-0.62). Students perceiving they would strengthen their belief in donation were more likely to disclose (OR=4.49; 95% CI 2.04-9.88). Family communication regarding donation must accommodate uncertainty; optimal approaches may emphasize candid discussion and reconsideration.