Mapping the Processes and Patterns of Family Organ Donation Discussions: Conversational Styles and Strategies in Live Discourse

Abstract

People in the United States report positive attitudes toward organ donation (OD); however there is a disjoint between pro-donation attitudes and declared-donor status. OD campaigns promote family discussions to increase donor status and compliance with OD wishes. Unfortunately, the discourse processes involved in family OD discussions have not been systematically studied. This investigation explores how families enact the recommendation to have a family OD discussion by mapping patterns, processes, and implications of 21 undirected family discussions. Analyses revealed 3 discussion styles: cooperative, collaborative, and challenging. Discussions were marked by a general pro–OD norm, a focus on individual rights and family loyalty, and 2 specific communication strategies used to explore individual boundaries, hypothetical ethical scenarios and hypothetical family scenarios. Finally, this investigation offers insight into the processes of OD discussions such as topic initiation, topic shifting, and establishing consensus. This research serves as a significant step toward enhancing competent discussions about OD.

ACKNOWLEDGMENTS

This article was written in loving memory of our colleague and friend, Amanda Kundrat, who is now deceased. The article is a direct result of her fervor to bring the communicative processes that influence OD decisions to the fore and includes data collected while she was a doctoral candidate at The Pennsylvania State University.

We would like to thank Anthony Roberto for his helpful critique of an earlier version of this manuscript. We also thank the Health Communication reviewers for their insight and suggestions. Finally, we thank two undergraduate research assistants, Sonia Morosin and Jennifer Ferland for their help in preparing the data for analysis.