STORY-TRÅD·politik

Brazil’s rate of organ donation refusal by relatives stands at 45%

The loss of a loved one is one of the most painful experiences a family can face, as they are confronted with the difficult decision of whether or not to authorize organ donation after brain death has been confirmed, in order to save the lives of strangers on the waiting list. In Brazil, the average rate of family members refusing organ donation hovers around 45 percent – a figure that varies between states and even between hospitals within the same city, highlighting that refusal depends not only on the people but also on institutional factors. According to Cristiano Franke, president of the Brazilian Association of Intensive Care Medicine (AMIB), many patients inform their families of their wish to donate organs, and many families would also like to honor that wish. However, he notes, in many cases a lack of support for family members and poor communication within hospitals – both public and private – is one of the main obstacles to successful organ donations. Notícias relacionadas:WHO director-general: Brazil is a global model for health care.New tech cuts rare disease diagnosis time in Brazil’s public care.“Families often do not receive all the necessary information in a timely manner and through an appropriate protocol to make the best decision. And medical teams often are not prepared to handle difficult conversations, using overly technical and inaccessible terms, or adopting approaches considered cold and businesslike in inappropriate settings,” said Franke. As a result, the association, in partnership with the Ministry of Health, trained 2,534 healthcare professionals from September 2025 through August 2026 to assist in the organ donation and transplantation process. To date, the program has exceeded its initial target of 2,000 trained participants by 25 percent. The goal of the courses developed and offered by the association is to increase the number of professionals prepared to carry out this process, including the improvement of communication to reduce families’ resistance to authorizing the removal of organs from relatives diagnosed with brain death. The training also aims to provide expertise on the various stages leading up to a donation, covering the identification of potential donors, the determination of brain death, and the clinical management of the potential donor, thereby making the process safer, Franke added. “Reaching over 2,500 trained professionals shows that we are succeeding in bringing technical knowledge to those on the front lines of a process that demands a great deal of responsibility. A diagnosis of brain death must follow strict criteria, as must the care of the potential donor and the dialogue with the family,” he stated. Among the difficulties family members face in agreeing to authorize transplants are understanding or accepting the diagnosis of brain death, religious beliefs, fear of compromising the body’s integrity, mistrust of the process, and lack of knowledge regarding the wishes the family member expressed while alive – or even the perception that healthcare professionals were more interested in the organs than in the patient or their family members. “Families are also concerned about bodily disfigurement, and we thoroughly explain how the procedure and the restoration of the body are carried out, which will leave no visible disfigurements during funeral rites such as the wake. They raise this issue very clearly, and we also need to explain it thoroughly and clearly,” he noted. According to the association, among the participants trained through August are 933 physicians, 473 of whom received training focused on determining brain death. The remaining participants – who include physicians, nurses, psychologists, social workers, nursing technicians, physical therapists, administrators, pharmacists, dentists, biologists, as well as a nutritionist and an educator – received instruction on donation and transplant management and the use of communication in critical situations. As of August, 73 courses had been held across 23 modules and involving activities in 25 Brazilian states. Eight more training sessions are still planned before the project concludes. Transplants in Brazil In 2025, 15,940 potential donors were registered across Brazil. Of this total, 4,335 became actual donors. Among the families interviewed, 4,200 did not authorize donation – the equivalent to 45 percent of the interviews conducted. In the same year, Brazil reached 20.3 actual donors per million people, compared to 19.2 in 2024.