Additional Aspects

Apart from the topical order of the questions in this interview, there were several aspects that were not directly introduced by the researcher but surfaced within the elaborations of the respondents. They were connected to the overall topic and provide valuable insight into the behavior and attitude of the German public.

4.5.1 Negative impact of scandal on organ donation intention

9 respondents explicitly mentioned that the scandal events had a direct negative impact on their considerations whether or not to be donors, either because they felt validated in their skepticism and it solidified their position or because it increased their uncertainty regarding the topic in a negative way:

“It has confirmed my attitude not to donate organs.” (Interview 18, male, 66 years old)

“It has discouraged me personally even more to get a donor card altogether.” (Interview 4,

female, 22 years old)

For two respondents, the scandal was directly responsible for their decision to withdraw their status as active donors:

“Due to the donation scandal back then, I stopped to be available for it. I had a donor card and was ready to donate but then I ripped it up.” (Interview 21, female, 66 years old)

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“It drove my change of mind regarding organ donation into the other direction in that I said that I don’t want that anymore under these circumstances.” (Interview 7, female, 34 years old)

4.5.2 Lack of general knowledge about organ donation

A dominant occurrence was that the majority of participants stated that they do not feel well- enough informed about the basics of organ donation in general. The 20 assembled statements for the code “lack of general knowledge about donation” show that people are convinced that the topic is not present enough, that information is vague and incomplete:

“What I find a bit irritating is that in general I don’t know exactly what goes on there. How it proceeds, how the order with the organs is, who receives what, etc. I feel poorly informed in general.” (Interview 10, male, 19 years old)

“Well, when you’re interested in organ donation and you do research somewhere on the internet, then I feel that you don’t find as much as you’d need to be sure that everything works.” (Interview 2, male, 21 years old)

That also contributes to uncertainty and avoidance to become an active donor:

“My general attitude is that I don’t know what happens there and that I’d rather keep my hands off of it then, especially how this all takes place, how fast and yeah, what actually happens to my body afterwards and that’s why I’d rather keep my distance.” (Interview 24,

female, 23 years old)

4.5.3 Role of own information-seeking behavior

An aspect that found frequent reference was one of self-reflection. 13 participants mentioned that their own information-seeking behavior or the lack thereof played a role in their state of knowledge. They stated that additional research on their part might have been necessary because the information supply they received was not satisfactory:

“Not much, but that always depends on you individually, how you approach the topic. I’m generally interested in it but to me that means that I have to do research myself.” (Interview

5, male, 58 years old)

“Backgrounds or information in greater detail, yeah, I don’t know whether it just wasn’t there or I didn’t search for it and should have searched more actively, anyway it wasn’t presented to me the same way as the headlines were.” (Interview 15, female, 28 years old)

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In parts, frustration could also be seen as a reason to lose interest to search for information independently:

“To be honest, I didn’t deal with it that much, suddenly it was all over the place and I was fed up at one point.” (Interview 17, male, 32 years old)

4.5.4 Impact of more information about consequences on donation intention

13 statements were collected in which participants assessed that more information about the improvement measures would have a positive effect on their decision to sign up as donors: “Yes, I would want that, it would convince me to become a donor. Transparency, honesty, safety.” (Interview 9, male, 22 years old)

“I’d surely consider to sign up but for that I must have precise information. Real background knowledge.” (Interview 05, male, 58 years old)

In contrast, 3 respondents stated that no amount of information could change their mind: “At the moment, that wouldn’t influence me at all; I would stand by my opinion and wouldn’t donate.” (Interview 19, male, 62 years old)

4.5.5 Trust / Distrust towards information sources

For 7 respondents, getting information is not necessarily the biggest issue. Their statements showed that they either suspected or outright claimed that they were not given the complete and true information:

“Whether we got enough reasons or information is anyone’s guess because you don’t know what else is kept hidden.” (Interview 18, male, 66 years old)

Other participants were convinced that they were deliberately misinformed by the media: “Well, I’d have to attack our media landscape for that and the older I get, the more I form the opinion that we’re also manipulated by the media, that we can’t get all information that’s actually necessary to decide correctly. So, I’m very skeptical towards that information because I know that some specific people could maybe influence it.” (Interview 6, male, 64

years old)

“I did not get enough information at all and even if I got more information, I’d always suspect that I get sugarcoated information, manipulated information and that they wouldn’t tell me as a potential organ donor all the things that were wrong there.” (Interview 1, female, 60 years

35 4.5.6 Improvement suggestions by respondents

Participants also engaged by making suggestions on how to improve the German organ donation system in general. Two respondents suggested that more donor engagement would be prompted if the sign-up process was changed from opt-in to opt-out. Other remarks proposed measures such as a constant relocation of physicians who perform organ

transplantations between hospitals or that the control oversight should no longer be privatized in the hands of the medical association and Eurotransplant. The majority of participants stressed the importance of more information about organ donation and the post-scandal consequences in order to get the attention of the public and regain their trust in the system: “Maybe that the whole thing is started as a nationwide initiative that says: ‘here’s the thing, we need organ donors because it saves people’s lives and we explain why it’s important and something went wrong in the past but we try to actively work on that’. And when you don’t have the information that someone actively works at improving it, you don’t see that it improves.” (Interview 8, female, 34 years old)

“I think it’s important that this marketing campaign gets intensified a bit and not only has the classic motto that organ donation is important and that you can act as a lifesaver. But maybe that the focus is put on the scandal again in the sense that the scandal doesn’t have anything to do with the readiness to donate and that a lot has been done and is still being done to improve it all somehow so that the public just has this safety that something was done and is still being done.” (Interview 4, female, 22 years old)

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