about organ donation apologetically or say that they are legally required to
do so receive far more refusals than procurement organization staff specifically trained in how to approach a family member.
100 The more tactful and
successful approach includes providing more information to the family and
spending more time with the family discussing the issues.
Many families learn about organ donation for the first time during the
approach for consent. The more surprised a family is about donation when
approached, the more likely they are to refuse.
102 The public education
campaign necessary to implement presumed consent would provide information sooner,
103 rather than surprising families with complex details during a particularly difficult time. This begins the process of fostering a culture that views donation as the norm, rather than the exception implied by
an opt-in system. Eventually, the decisional inertia that presently works
against donation should abate as donation becomes the more conservative
and commonplace decision.
104 This will further relieve the burden on family
members, and may also increase the supply of donor organs and tissues.
The support provided to families would also change in a presumed consent system. Procurement organization staff are well-trained in how to discuss donation with family members and provide appropriate support during
and after the donation process.
106 Many health care staff are, as well. But,
generally speaking, staff involved in the consent process are not social
workers, counselors, or mental health professionals,
107 although procurement organizations do frequently provide families with referrals to such
108 This is indicative of the proper role for procurement organization staff as facilitators of all aspects of donation, from consent to procurement to family support. For registered donors, this process works well.
101. Id. The procurement organization approach results in more donations even when
controlling for factors such as initial family reaction. Id.
102. Id. at 74.
103. Organ Donation: Presumed Consent to Start in December 2015, BBC NEWS (Sept.
10, 2013, 10:05 AM), http://www.bbc.co.uk/news/uk-wales-24032031 (“[P]eople will be
given plenty of information on how the new system works and what their choices are.”).
104. See William Samuelson & Richard Zeckhauser, Status Quo Bias in Decision Making, 1 J. RISK & UNCERTAINTY 7 (1988) (asserting that individuals will generally stick with
the status quo when faced with important decisions).
105. See Rosemary A. Robbins, Signing an Organ Donor Card: Psychological Factors,
14 DEATH STUD. 219, 226 (1990) (asserting that psychological stress and physical anxiety
are notably correlated with an unwillingness to donate organs).
106. Liva Jacoby & James Jaccard, Perceived Support Among Families Deciding About
Organ Donation for Their Loved Ones: Donor vs. Nondonor Next of Kin, 19 AM. J. CRITICAL
CARE e52, e53 (2010).
108. E.g., LifeNet Health, How Does the Process Work?, http://lifenethealthopo.org
/all_about_donation/how_does_the_process_work (last visited May 22, 2014) (outlining donor family support up to eighteen months after donation).