Deal breakers in the organ donation request process.

Organ donation consent rates have stagnated at about 50%, while the need for transplantable organs continues to increase. This article focuses on consent rates of families who make a donation decision for a deceased loved one, and how social marketing efforts to increase organ donation can be enhanced by better understanding the decision-making process these families use. Three categories of factors bear significantly on that decision which, if not addressed properly, will very likely result in a refusal to donate. These "deal breaker" categories include (1) family predisposition and family care, (2) requestor characteristics, and (3) request dynamics. Recommendations are made toward developing best practices protocols which roughly parallel promotion activities and the selling process utilized in commercial marketing for overcoming these barriers.