The Family Member’s Decision to be a Kidney Transplant Donor

Abstract

Kidney transplantation as a medical innovation involves the entire extended family in a major decision. Will a relative donate a kidney to help save the life of a dying patient? It is the aim of this study to use the transplant experience as a research site to enhance our knowledge of how individuals in a family attempt to make a major and highly stressful decision. Over a 1½ year period 124 families were followed through the transplant experience with questionnaires and repeated qualitative interviews. The results indicate that only a minority of related donors and non-donors (non-volunteers) perceived themselves as going through a rational decision-making process involving deliberation and conscious choice. Instead the majority seemed to follow one of two patterns compatible with Schwartz’s “moral-decision-making” model. First, the vast majority of donors, and a substantial minority of nondonors appeared to make an instantaneous choice and commitment with deliberation. Secondly, other subjects postponed donation without a conscious choice being made. A few donors of this type became “locked into” donation by taking a few first steps in the testing procedure; while a substantial minority of non-donors drifted into non-donation without arriving at a clear-cut decision.