'It's like being conscripted, one volunteer is better than 10 pressed men': A qualitative study into the views of people who plan to opt-out of organ donation



Miller J, Currie S, McGregor LM & O'Carroll RE (2020) 'It's like being conscripted, one volunteer is better than 10 pressed men': A qualitative study into the views of people who plan to opt-out of organ donation. British Journal of Health Psychology, 25 (2), pp. 257-274.

Objectives. To overcome the shortage of organ donors, Scotland and England are introducing an opt-out organ donor registration system in 2020. This means individuals will be automatically considered to consent for donation unless they actively opt-out of the register. Research has found that emotional barriers play a key role in donor decisions under opt-in legislation, yet little is known about factors that influence donor decisions under opt-out consent. Our objectives were to investigate attitudes towards organ donation and opt-out consent from individuals who plan to opt-out, and to explore the reasons why they plan to opt-out. Design. Qualitative interview study Methods. Semi-structured interviews were conducted with 15 individuals from Scotland (n=14) and England (n=1) who self-reported the intention to opt-out of the register following the legislative change to opt-out. The interviews were transcribed verbatim and analysed using thematic analysis. Results. Three main themes were identified; (1) consent versus coercion, which describes the perception of freedom of choice under an opt-in system and fears of “Government interference” and threatened autonomy under opt-out, (2) self-protection, encompassing fears of medical mistrust, bodily integrity concerns and apprehension regarding the recipient selection process. Lastly, (3) ‘riddled with pitfalls’, which includes the notion that opt-out consent may increase susceptibility of stigma and reproach when registering an opt-out decision. Conclusions. This study reinforces existing opt-in literature surrounding medical mistrust and bodily integrity concerns. A threat to one’s autonomous choice and heightened reactance arising from perceptions of unwarranted Government control have emerged as novel barriers.

organ donation; opt-out consent; medical mistrust; bodily integrity; government control; thematic analysis

British Journal of Health Psychology: Volume 25, Issue 2

Publication date31/05/2020
Publication date online30/01/2020
Date accepted by journal08/01/2020

People (4)


Dr Sinead Currie

Dr Sinead Currie

Lecturer, Psychology

Dr Lesley McGregor

Dr Lesley McGregor

Senior Lecturer in Psychology, Psychology

Miss Jordan Miller

Miss Jordan Miller

PhD Researcher, Psychology

Professor Ronan O'Carroll

Professor Ronan O'Carroll

Professor, Psychology


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