Organ donation and family decision-making within the Spanish donation system

This study analyses the variables associated with the decisions made by fam ilies of potential organ donors to give or deny consent For the extraction of organs. Different indicators were recorded in 68 cases of family intervi ew for petition of consent carried out in 13 Spanish hospitals. Those varia bles showing the strongest relation with family decision (donation:refusal of consent) are knowledge shown by the family about the deceased's wishes w ith regard to donation (p <0.001), family relationship climate (p <0.01), e xpression of family's satisfaction level with medical attention received (p <0.01) and number of relatives present at the consent request interview (p <0.01). Logistic regression on family decision with considered variables c orrectly predicted relatives' final choice in 98.4% of cases. In turn, mult ivariate exploratory analysis highlights a potential association between th e expression of the deceased's wishes and several concurrent variables in t he process (satisfaction with personal treatment and medical attention rece ived. emotional reactions in the interviews of notification of death and co nsent request). It also shows that patterns of reaction and family particip ation in this process may vary according to the sex of the deceased relativ e. Results suggest that both educational efforts devoted to promoting a pos itive attitude toward donation in the general population and the training o f health professionals involved in the generation of organs may be key fact ors in reducing organ shortage. (C) 2001 Elsevier Science Ltd. All rights r eserved.