. 2021 Sep 24;10(19):e020820. doi: 10.1161/JAHA.121.020820

Table 3.

Themes With Exemplar Quotations

Theme	Men N=301 (donors: N=195; non‐donors: N=106)	Women N=366 (donors: N=232; non‐donors: N=134)
1a. Donors: willingness to donate
Desire to help others	“I have just always thought it was important to help others in need, and if something were to happen to me, I would want someone else to benefit from the use of my organs. It would make me feel like I was truly making a difference by giving someone else the gift of life.” N=135	“I want to help people if they can use my organs.” N=181
Personal experience with organ donors/recipients	“I have close friends who have (1) received organ donations and (2) survived as a result of organ donations.” N=23	“My mother needed a donation and the person who donated to her saved her life. We were so grateful and this person was so kind. I decided I want to give back and help someone if I can.” N=44
Believing organs would have no use to the donor once dead	“I want to be able to give what I don't have a use for anymore.” N=60	“I won’t need my organs when I am dead, other people who are still living would put them to good use.” N=75
1b. Donors: hesitations when registering
No hesitations	“I did not have any hesitations becoming an organ donor.” N=162	“No hesitations at all. I was happy to sign up to be an organ donor.” N=178
Medical mistrust		“Yes, I've read that sometimes organs are harvested while you're still alive and that if doctors know you're an organ donor your life might not be top priority.” N=23
Organ donation is unsettling		“The thought of being dissected and harvested for your organs is a little unsettling even if you're already deceased.” N=30
2a. Non‐donors: feelings regarding deceased organ donation
No desire to donate	“I don’t intend on becoming a registered deceased organ donor.” N=28	“I really do not want to be an organ donor. I know it could save lives. I just don't like the idea of being all cut up.” N=22
Considering donation	“It is amazing thing after our death our organs will help other people it is very useful and nice thing so I feel happy.” N=35	“I think it is one of the most selfless things you can do. if something happened to me I would like to know that my organs could help save someone else.” N=53
Uncertainty about feelings	“Personally I'm still unsure and quite uncertain about it because I fear that my organs might go to someone that is undeserving or I fear mishandling of my organs by people.” N=36	“I feel unsure about it.” N=61
2b. Non‐donors: reasons against deceased organ donation (Why?)
No reason (don’t want to donate)	“I don't even like to think about it; I want to help, but I could never get up the courage to volunteer for organ donation.” N=49	“I just don't want to be an organ donor.” N=54
Medical mistrust		“Sometimes people are not "dead" yet. I've read articles and heard stories about this. It scares me, as I used to be a donor.” N=20
2c. Non‐donors: methods to change decision about donation
More information	“Just more information so [that] I can give fully informed consent or denial.” N=43	“Learning more about donations and what it all means and how it all works.” N=63
More trust in medical system		“Concrete absolute proof that the person is totally dead before being cut on. Also, the doctors should not be able to coerce a family member into donating before it's known if the person even has a 1% chance of recovery.” N=19
3. Feelings regarding donation of family member’s organs
My decision depends on my family member's wishes	“It depends on their wishes. I would take that into consideration first. If I didn't know how they felt, I might be inclined to donate their organs.” N=134	“I do not know. I would only donate their organs if they had already given me permission to do so.” N=146
My family member will not need their organs after death and should be used to help others	“Absolutely, I would. If my family member wasn't going to recover and had no use for their organs, someone else should be able to live and carry out a normal life; my family member's organ/s would be a life‐giving gift.” N=80	“Yes, I would donate their organs. The family member’s organs aren’t going to benefit them after death, but it might greatly benefit someone else.” N=149
4. Feelings regarding donation of spouse’s organs
My decision depends on my spouse's wishes regarding donation	“I would if she was willing to. I wouldn't want to go against their wishes.” N=74	“I would accept. I think he trusts me to make that decision for him and that I would do as he wished.” N=87
My spouse will not need their organs after death	“Yes. I would not keep her alive per our agreement. The organs will be more useful to someone that needs them.” N=44	“Yes, I'd donate his organs because he doesn't need them and he wouldn't want to live as a brain dead vegetable.” N=76

Theme

Men

N=301 (donors: N=195; non‐donors: N=106)

Women

N=366 (donors: N=232; non‐donors: N=134)

1a. Donors: willingness to donate

Desire to help others

“I have just always thought it was important to help others in need, and if something were to happen to me, I would want someone else to benefit from the use of my organs. It would make me feel like I was truly making a difference by giving someone else the gift of life.”

N=135

“I want to help people if they can use my organs.”

N=181

Personal experience with organ donors/recipients

“I have close friends who have (1) received organ donations and (2) survived as a result of organ donations.”

N=23

“My mother needed a donation and the person who donated to her saved her life. We were so grateful and this person was so kind. I decided I want to give back and help someone if I can.”

N=44

Believing organs would have no use to the donor once dead

“I want to be able to give what I don't have a use for anymore.”

N=60

“I won’t need my organs when I am dead, other people who are still living would put them to good use.”

N=75

1b. Donors: hesitations when registering

No hesitations

“I did not have any hesitations becoming an organ donor.”

N=162

“No hesitations at all. I was happy to sign up to be an organ donor.”

N=178

Medical mistrust

“Yes, I've read that sometimes organs are harvested while you're still alive and that if doctors know you're an organ donor your life might not be top priority.”

N=23

Organ donation is unsettling

“The thought of being dissected and harvested for your organs is a little unsettling even if you're already deceased.”

N=30

2a. Non‐donors: feelings regarding deceased organ donation

No desire to donate

“I don’t intend on becoming a registered deceased organ donor.”

N=28

“I really do not want to be an organ donor. I know it could save lives. I just don't like the idea of being all cut up.”

N=22

Considering donation

“It is amazing thing after our death our organs will help other people it is very useful and nice thing so I feel happy.”

N=35

“I think it is one of the most selfless things you can do. if something happened to me I would like to know that my organs could help save someone else.”

N=53

Uncertainty about feelings

“Personally I'm still unsure and quite uncertain about it because I fear that my organs might go to someone that is undeserving or I fear mishandling of my organs by people.”

N=36

“I feel unsure about it.”

N=61

2b. Non‐donors: reasons against deceased organ donation (Why?)

No reason (don’t want to donate)

“I don't even like to think about it; I want to help, but I could never get up the courage to volunteer for organ donation.”

N=49

“I just don't want to be an organ donor.”

N=54

Medical mistrust

“Sometimes people are not "dead" yet. I've read articles and heard stories about this. It scares me, as I used to be a donor.”

N=20

2c. Non‐donors: methods to change decision about donation

More information

“Just more information so [that] I can give fully informed consent or denial.”

N=43

“Learning more about donations and what it all means and how it all works.”

N=63

More trust in medical system

“Concrete absolute proof that the person is totally dead before being cut on. Also, the doctors should not be able to coerce a family member into donating before it's known if the person even has a 1% chance of recovery.”

N=19

3. Feelings regarding donation of family member’s organs

My decision depends on my family member's wishes

“It depends on their wishes. I would take that into consideration first. If I didn't know how they felt, I might be inclined to donate their organs.”

N=134

“I do not know. I would only donate their organs if they had already given me permission to do so.”

N=146

My family member will not need their organs after death and should be used to help others

“Absolutely, I would. If my family member wasn't going to recover and had no use for their organs, someone else should be able to live and carry out a normal life; my family member's organ/s would be a life‐giving gift.”

N=80

“Yes, I would donate their organs. The family member’s organs aren’t going to benefit them after death, but it might greatly benefit someone else.”

N=149

4. Feelings regarding donation of spouse’s organs

My decision depends on my spouse's wishes regarding donation

“I would if she was willing to. I wouldn't want to go against their wishes.”

N=74

“I would accept. I think he trusts me to make that decision for him and that I would do as he wished.”

N=87

My spouse will not need their organs after death

“Yes. I would not keep her alive per our agreement. The organs will be more useful to someone that needs them.”

N=44

“Yes, I'd donate his organs because he doesn't need them and he wouldn't want to live as a brain dead vegetable.”

N=76

The number of participants describing the themes may be higher than the total participants since a single participant may express more than one theme. Themes were maintained after unmasking participant sex if the theme was repeated among at least 10% of the population of donor men or women, or non‐donor men or women, or of all‐comer men or women.