Communication: the ethical side to organ donation

Written by Dr. Chandrima Chatterjee, Bhagyashree Dutta, Dr. Anamika Roy

organ donation

Organ donation is a much debated and sought-after topic, yet numerous bioethical controversies are associated with it. With the advent of organ black markets, revised regulations and increased precautions for donating organs. As far as bioethical concerns are there, one factor is communicating the different facets to the family members or relatives. This paper will look into the various prototypes of donors, their perceptions about organ donation, their relatives and the role of communication in the arena of organ donation.

The first subject is the prototypes of donors and how communication can be used to determine the people’s intentions in expressing their organ donation wishes. Hyde and White have applied the Theory of Planned Behaviour (TPB) to analyse and evaluate. They had proposed a model for each behaviour of registering consent on an organ donor register. They were then discussing the organ donation decision with a partner of family members to examine the contribution of attitude, subjective norm, PBC, self-identity, moral norm (extended TPB predictors) and donor prototype evaluations and at the same time, controlling for the effects of past behaviour and respondent type. Through this study, it has been found that the donor prototype plays a significant role in communicating the intentions to donate the organs. There is a substantial relation of the type and how they have done the public disclosure of their wishes. The family members’ reaction to each kind has also been different. The fluidity in accepting their wants and also consenting to the same are crucial factors. This study also lays the foreground of how communication has played a significant role and realises further interventions in the same area. It is imperative to communicate the wishes of the donor to the family members to avoid any bioethical issues and also to make an informed decision. [1]

Family discussion is an exciting communication process to study to understand people’s willingness to become organ donors. The most important aspect of the family discussion is that they are responsible for organ donation. The willingness of the donor must be communicated to them. This gap has led to many people who are awaiting an organ than organ donors. One of the articles talks about the importance of Willingness To Communicate (WTC) scale has been used. The significance of the scale has also been discussed. The role of this is the encouragement to communicate the wishes of the donor to the family members. Other important factors like Prior Thought and Intent (PTI) and the Credibility of Messages. The ease with which the organ donation process is initiated and completed depends on the family members’ knowledge and the wishes communicated to them. [2]

One of the most direct ways to dramatically increase deceased donors’ number is to improve the “conversion rate.” That figure represents the percentage of deceased individuals registered as organ donors whose family consented to organ donation after death. Anxiety is an essential variable in efforts to increase information-seeking behaviours. It is believed that increased information seeking will reduce uncertainty about the issue and thereby improve family discussion rates. Another critical variable in health and well-being is religious beliefs or religiosity. Both religious beliefs and family discussions are essential factors in determining the anxiety towards accepting the wishes of donating the organs after death. The data from different studies suggest that researchers interested in examining the role that anxiety plays in determining the information-seeking strategies used to discuss organ donation should also consider the religious concerns of the individuals involved and the role that religion plays in their everyday lives. The evidence is vital in getting the idea of how the problems related to communication can be addressed. [3][4]

Research has shown how psychological reactance affects individuals’ responses to health promotion messages, but little is known about how family processes might moderate the reactance process. Organ donation is a significant health issue in which the interplay of interpersonal and mediated communication might have life-saving potential. According to psychological reactance theory, people value their ability to choose among alternatives. When a person perceives a threat to that freedom, psychological reactance (i.e., motivation to restore freedom of choice) ensues. The theory proposes that all persuasive messages constitute a potential freedom threat. Although the degree to which a compelling message is perceived as a freedom threat varies among individuals, the magnitude of a freedom threat directly predicts reactance intensity. Reactance, in turn, energises individuals to re-establish their threatened freedoms by maintaining unfavourable attitudes toward the advocacy or forming intentions to act contrary to the advocated behaviour in the future.

All these factors are essential in playing the role behind how communication is vital in organ donation decision-making.


  1. Hyde MK, White KM. Disclosing donation decisions: the role of organ donor prototypes in an extended theory of planned behaviour. Health Education Research. 2009 Dec 1;24(6):1080-92.
  2. Smith SW, Kopfman JE, Lindsey LL, Yoo J, Morrison K. Encouraging family discussion on the decision to donate organs: The role of the willingness to communicate scale. Health Communication. 2004 Jul 1;16(3):333-46.
  3. Morse CR, Afifi WA, Morgan SE, Stephenson MT, Reichert T, Harrison TR, Long SD. Religiosity, Anxiety, and Discussions About Organ Donation: Understanding a Complex System of Associations. Health Communication. 2009 Mar 10;24(2):156-64.
  4. Afifi WA, Morgan SE, Stephenson MT, Morse C, Harrison T, Reichert T, Long SD. Examining the decision to talk with family about organ donation: Applying the theory of motivated information management. Communication Monographs. 2006 Jun 1;73(2):188-215.
  5. Scott AM, Quick BL. Family communication patterns moderate the relationship between psychological reactance and willingness to talk about organ donation. Health Communication. 2012 Oct 1;27(7):702-11.

Dr. Chandrima Chatterjee is a dental surgeon and currently a postgraduate student, pursuing Master of Public Health (Global Health) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.

Bhagyashree Dutta is a physiotherapist currently a postgraduate student, pursuing Master of Public Health (Health Policy) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.

Dr. Anamika Roy is a dental surgeon and currently a postgraduate student, pursuing Master of Public Health (Health Policy) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.



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