Approximately 10% of family members who consented to organ donation reported moderate-to-high regret at 1-4 year follow-up, according to van Leiden et al.’s Dutch longitudinal cohort study published in Transplantation (2006). Regret was lowest when the family’s decision aligned with the deceased’s previously known or registered wishes — a structural finding that suggests the primary driver of consent-side regret is decision ambiguity rather than the donation itself. UNOS data document that approximately 10,000 US families face next-of-kin donation decisions annually, typically under acute clinical time pressure with limited opportunity for deliberation. The constrained decision environment contributes to post-hoc doubt independent of the direction of the choice.
Refusal produced nearly three times the regret rate: approximately 28% of next-of-kin who declined consent expressed uncertainty or regret at follow-up, with regret highest among those who later learned transplant recipients had survived and benefited, and among those who refused despite the deceased having been a registered donor. A 2021 PMC study of organ donation willingness found that 68.1% of respondents were willing to donate their own organs but only 51.8% would consent for a relative — a 16-point gap — and that 16.1% of people with a registered donor family member said they would still refuse. This family-veto pattern is a documented source of post-decision regret: overriding a stated wish and later encountering evidence of its value is a regret-generating structure that appears reliably in the refuser literature.
Under Gilovich and Medvec’s temporal model, inaction typically generates more durable long-term regret, and the 18-point gap in this dataset is consistent with that pattern. The caveat is that the underlying data come entirely from a single Dutch research team, in a cultural and legal context that may amplify donation-positive norms. Sample sizes in transplant-psychology research are small, and no large-scale direct-regret survey replicating these findings in a US population currently exists. The directional finding — that refusing generates roughly three times the long-term regret of consenting — is replicated qualitatively across the broader transplant-psychology literature even where precise rates are not reported.