It Is All About Control: Understanding Reluctance to Register for Organ Donation

This article tests the theory that anxiety about death causes feelings of lack of control, which, with other factors, results in reluctance to donate organs, despite endorsement of the act. Using a survey of U.S. and U.K. registered organ donors and unregistered adults (N = 777), we tested the impact of trust in medical professionals, perceived importance of information on the transplant processes, anxiety regarding loss of control at one’s end-of-life, and a prosocial view of organ donation on willingness to register as donor. Structural analyses show that control mediated the associations of trust and information with willingness, while prosocial did not predict willingness. The findings explain the gap between stated attitudes and actual behavior, and suggest that framing donor card registration and organ donation as a way to gain control over the loss of agency in death and dying may encourage organ donation.