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(1995) argued that, at best, organs are being retrieved from only half of all suitable
donors. Thus, many patients in desperate need remain on the waiting list for extended
periods of time or even die while life-saving organs are being buried. Moreover, the
consequences of organ shortages are not only measured in lives saved; although the cost
of organ transplantation remains high, it is exceeded by the cost of providing dialysis or
terminal care (Horton & Horton, 1991).
Public opinion surveys consistently show that people are well aware of the need
for donor organs, but remain reluctant to have their organs donated or to consent to the
donation of organs from relatives (Evans, Orian & Ascher, 1992). Research has been
directed toward investigating the causes for this discrepancy, examining the impact of
such barriers as misconceptions about the donation process, the role of the doctor in the
donation process, and religious beliefs as they relate to donation (Horton & Horton,
1990). Other studies have examined beliefs that the doctor might not do all that he or she
could to save a potential donor, concerns about surgical disfigurement of the body
(McNamara et al., 1999), and perceptions that signing a donor card is a fearful activity
(Kopfman & Smith, 1996). Similarly, Riether and Mahler’s (1995) review identified
rumors, misconceptions, cultural beliefs, media misinformation, and lack of information
as the keys to resistance. Research has also determined demographic (Callender, Bayton,
Yeager, & Clark, 1982) and psychological variables (Belk & Austin, 1986; Cleveland,
1975; Mahoney & Pechura, 1980) that impact likelihood of donation. Siminoff, Gordon,
Hewlett, & Arnold’s (2001) study of factors influencing families’ consent for organ
donation is perhaps the most complete. It determined that the following factors relate to
donation decisions: ethnicity, patient’s age and cause of death, prior knowledge of the
Convention