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Attitudes to organ donor registration in England under opt-out legislation

Lookup NU author(s): Dr Kate SwainstonORCiD, Dr Grant McGeechan



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Introduction: In England, everyone is considered an organ donor unless they have registered for opt-out donation. Research question: This study evaluated positive statements and negative affective attitudes against anticipated organ donor status and whether the order the attitudes and statements were presented impacted organ donor intention under an opt-out system. Design: A quasi-experimental mixed between-within design was employed with participants assigned to 1 of 2 conditions. Participants in the first condition received negative affective attitude statements followed by positive statements. This was reversed in the second condition to combat ordering effects. Participants (N = 679) were asked about their donor status under an opt-out system. There were 3 groups: opt-in (actively), opt-out/not sure, and deemed consent (no objection). Organ donor intentions were measured at 3 intervals: baseline, post positive attitude statements, and post-negative attitude statements. Results: Approximately 10% of participants would opt-out or were unsure of their intentions to be an organ donor under an opt-out system. Significant effects were found in both positive statements and negative affective attitudes. All groups expressed greater medical mistrust and were most influenced by cognitive attitudes. Conclusions: Under the opt-out system in England, it is anticipated that the majority would actively opt-in or have no objection to being automatically registered as an organ donor. Public health campaigns would benefit from promoting the most influential positive statements and refuting the most detrimental negative attitudes to increase intentions of those who plan to opt-out or are unsure.

Publication metadata

Author(s): Clark N, Copping L, Swainston K, McGeechan G

Publication type: Article

Publication status: Published

Journal: Progress in Transplantation

Year: 2023

Volume: 33

Issue: 3

Pages: 208-215

Online publication date: 20/07/2023

Acceptance date: 13/04/2023

Date deposited: 17/04/2023

ISSN (print): 1526-9248

ISSN (electronic): 2164-6708

Publisher: Sage Publications Inc.


DOI: 10.1177/15269248231189869

ePrints DOI: 10.57711/zc0h-0s52


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