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Nursing issues
Competing wishes of next-of-kin versus the deceased when it comes to organ donation consent
  1. Adnan Sharif1,2
  1. 1 Department of Nephrology and Transplantation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2 Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Adnan Sharif, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; adnan.sharif{at}

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Commentary on: Shepherd L, O'Carroll RE, Ferguson E. Assessing the factors that influence the donation of a deceased family member’s organs in an opt-out system for organ donation. Soc Sci Med. 2023 Jan;317:115 545. doi: 10.1016/j.socscimed.2022.115545. Epub 2022 Nov 17.

Implications for practice and research

  • Next-of-kin approval for organ donation is based on knowledge of the deceased’s wishes but mediated by anticipated regret and their own attitude.

  • Targeted research exploring next-of-kin approval in organ donation settings, including behaviour change interventions, is required.


Countries have either opt-in or opt-out legislation to support organ donation. With opt-out systems, presumed or deemed consent occurs when an individual has made no explicit decision either way. While many believe deemed consent facilitates more organ donation, differences in actual organ donation rates are negligible.1 This could be due to the requirement for next-of-kin approval within both …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.