Determinants of Lack of Consent for Deceased Organ Donation Among Nurses and Physicians: A Cross-Sectional Study

BACKGROUND Deceased organ donation is the principal source of transplantable organs; however, organ shortages remain a major public health challenge. Healthcare professionals play a pivotal role in shaping societal attitudes toward transplantation. This study aimed to identify sociodemographic, psychological, and attitudinal factors independently associated with lack of willingness to consent to deceased organ donation among nurses and physicians working in dialysis units. MATERIAL AND METHODS A nationwide cross-sectional survey was conducted in Poland between February 2023 and June 2024 among 850 nurses and 243 physicians. Data were collected using paper-based and online questionnaires, incorporating sociodemographic variables, donation-related attitudes, and validated psychometric scales assessing life satisfaction, self-esteem, self-efficacy, and empathy. The primary outcome was lack of willingness to consent to deceased organ donation. Group comparisons were performed using Mann-Whitney U and chi-square tests. Multivariable logistic regression identified independent determinants. RESULTS Overall, 35.2% of participants either declined or did not clearly express willingness to consent to deceased organ donation. Higher levels of personal distress were associated with increased odds of lack of willingness to consent (B = 0.05; OR = 1.05; 95% CI, 1.00-1.10; P = 0.04), whereas higher empathic concern was associated with decreased odds (B = -0.06; OR = 0.94; 95% CI, 0.89-0.98; P = 0.01). Belief in the safety of blood donation was linked to lower odds of lack of willingness to consent (B = -0.28; OR = 0.76; 95% CI, 0.63-0.91; P < 0.001). The strongest association was observed for acceptance of organ donation from a deceased close family member (B = -2.36; OR = 0.09; 95% CI, 0.07-0.13; P < 0.001). Donation-related beliefs demonstrated stronger associations with consent attitudes than sociodemographic characteristics. CONCLUSIONS Unwillingness to consent to deceased organ donation among dialysis staff was associated with empathy dimensions and donation-related beliefs.