African American Consent and Nonconsent Cases: Are There Significant Differences?

Abstract

Background Previous research has examined the differences in organ donation consent rates between African Americans and other racial/ethnic groups. However, there is limited examination of whether differences exist between African American families that consent and those that do not. Objective To examine if there are significant differences between African American families that consent to donation compared to those that do not. Methods A random sample of 120 African American potential donor cases from an academic medical center between 1997 and 2004 were included in this study. Variables of interest included next-of-kin relationships, family interactions, knowledge of donor wishes, family initiation of the donation discussion, and satisfaction with the donation process. Results The data include 32 consent and 88 nonconsent cases. Compared to nonconsent cases, consent cases differed significantly in next-of-kin knowledge of donor wishes, frequent involvement of parents, and infrequent involvement of spouses. Donor wishes were known in 19% of consent cases but in none of the nonconsent cases. A parent was the dominant next-of-kin decision maker in 68% of consent cases, compared to 36% of nonconsent cases. A spouse assumed the dominant role in 29% of nonconsent cases but in only 6% of consent cases. Of these differences, wishes known, parental involvement, and spousal involvement were statistically significant ( P= .000, P= .002, and P= .013, respectively). Conclusions The results highlight the statistically significant differences between African American consent and nonconsent cases: knowledge of donor wishes and those involved in the donation decision. These results reinforce the importance of programs that encourage African American families to discuss donation with loved ones.