African American consent and nonconsent cases: are there significant differences?

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.