Mapping the processes and patterns of family organ donation discussions: Conversational styles and strategies in live discourse

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.