The influence of mothers in Family deceased organ donation decisions

introduction: Increasing family consent to deceased organ donation is key to addressing the transplant shortage. The human and financial costs of organ failure associated with the epidemic of chronic disease caused by renal failure and
diabetes, has led to a range of strategies designed to increase family consent to deceased organ donation in Australia. Despite these efforts, Australian organ donation rates remain modest and have recently declined. Why are Australian families reticent to donate organs after death, and who influences donation
decisions? objectives: To present one unexpected finding which emerged from a qualitative study that identified mothers as the major influencers of the decision-making process of deceased organ donation. methods: A study was conducted using an exploratory case study approach. Following ethics approval a qualitative snowball sampling recruitment strategy across Australia was used to invite families who had made a deceased organ donation decision, within the previous three year period, to participate in the study. This led to interviews with twenty two participants from nine families. Four families had declined organ donation and five families agreed. The transcribed interviews were analysed thematically and a theoretical framework was utilised. results: The unexpected finding was that mothers were the key decision makers in all consent decisions in this study. The study also found that women, particularly mothers played a significant influencing role in family decision-making processes and were the key decision-makers in eight of the nine family decisions examined in this study. The decisions were made in the context of DCD and DBD and included circumstances when family members were witness to the events leading to death. The wishes of the deceased were significant to the families but were not the most important influencing factor in the decisions. The idea that mothers utilise deep hope to protect their loved one and family was most influential in the decisions. It is known that women are more likely to sign donor cards and to respond in organ donation studies, however, there has been little specific examination of the implications of this phenomenon in the process of deceased organ donation decision-making. conclusion: The findings have implications for consent and non-consent in deceased organ and tissue donation decisions and it is recommended that there should be further qualitative study to examine this phenomenon which may be culturally specific to Australia