Attitudes towards organ donation in Germany: Qualitative analyses supplementing quantitative evidence

Background: To this day, the general population's attitude towards post-mortem organ donation has primarily been analyzed using quantitative representative surveys. These studies presuppose the willingness of the interviewees to participate. Since this agreement can be positively correlated with the willingness to donate organs, a systematic bias of the samples in favor of people willing to donate cannot be excluded. Using innovative qualitative databases and methods, rarely observed positions and arguments can be systematically identified. In this way, existing quantitative empirical studies can be beneficially supplemented. Methods: This qualitative-empirical study analyzes online discussion threads applying the GABEK (R) method (Software WinRelan (R)). Differentiated according to positive and negative attitudes towards organ donation, determinants of attitudes are extracted and condensed using network graphs. A similar procedure is used to work out assessments of alternative solutions to the existing scarcity problem in the German organ allocation system. Results: Discussants with a favorable attitude are mainly motivated by altruism and reciprocity. A disapproving attitude is particularly due to problems with the concept of brain death and distrust concerning the health and organ donation system. It can be demonstrated that negative attitudes are more often than not based on missing information and misinformation. With regard to alternative system solutions, monetary compensations are regarded positively, whereas the opt-out solution ("Widerspruchslosung") and concepts based on reciprocity are discussed controversially. Conclusion: There is still a great need for information and trust-generating work in the German organ donation and allocation system. Qualitative analyses in addition to quantitative evidence are necessary in order to localize these needs and concretize their content.