This multisite, qualitative study of 78 family-pair dyads provides rich data on the reasons people cite for (not) wanting to sign an organ donor card in the context of family conversations. In this study, dyads were videotaped as they discussed 8 questions pertaining to their views on organ donation, beginning with the most general opinions and progressing to more detailed questions. Analysis of the transcribed data revealed that the most common reasons for wanting to donate organs were based on religion or a desire to help other people in need. The most common reasons cited for not wanting to donate organs were mistrust (of doctors, hospitals, and the organ allocation system), a belief in a black market for organs in the United States, and deservingness issues (that one's organs would go to someone who brought on his or her own illness, or who could be a "bad person"). One of the most surprising findings is that religion is offered far more often as a rationale for wanting to help sick people through organ donation than it was for not wanting to donate organs. These findings both support and contradict past studies based on quantitative survey data. Implications for the construction of more effective future organ donor campaigns are discussed.

Researchers are already aware that decision making about health issues is not necessarily driven by rational or cognitive-based decision-making processes. This appears to be especially true for the decision to donate organs. Although hints about what is actually driving the decision-making process are scattered throughout the literature, noncognitive factors have not been tested systematically. Structural equation modeling of data gathered from 4426 participants at six different geographic locations in the United States demonstrates that cognitive-based factors (such as knowledge about donation) are less influential on the decision to donate than noncognitive variables such as the desire to maintain bodily integrity, worries that signing a donor card might 'jinx' a person, and medical mistrust.

Researchers and practitioners who have sought to understand public reluctance to donating organs in spite of favorable attitudes toward organ donation have long thought that belief in myths about donation contribute to the problem. How these myths emerged and more important, why they have persisted in spite of national education campaigns is not clear. In the absence of direct personal experience with organ donation or transplantation, we believe that most people receive their information about donation through the media. In this study, we identify all entertainment television shows with organ donation storylines or subplots broadcast on ABC, NBC, CBS, and FOX from 2004-2005. Frame analysis reveals 2 competing metaframes: the moral corruption of the powerful and organ donors are good people. In addition to the metaframes, 4 secondary frames, and 6 tertiary frames are identified. Organ donation is framed in mostly negative terms, with a few notable exceptions. Recommendations for how to address negative framing of organ donation in the media are offered.

In this study, 78 family pair dyads (spouses, parent-child pairs, or siblings) were brought into an interaction laboratory set up like a living room. After being briefed on the study, family members discussed a series of eight questions about their thoughts and opinions about organ donation. Thematic analysis of the thousands of pages of transcripts revealed that family members believe that they receive important information about organ donation through the media. Unfortunately, the most influential information came from sensationalistic, negative media portrayals. The myths that seem to be the most actively referenced by the media include premature declaration of death, the transference of personality traits from donor to recipient, a US black market for organs, corruption in the medical community, and corruption in the organ allocation system (which allows celebrities to get transplants first). Although these are not the only myths that the generally public holds to be true, the media is a powerful source of support for these particular myths. Therefore, such myths must be countered effectively if greater consent for organ donation is to be attained.

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