Acceptance of Opt-Out Organ Donation in Saudi Arabia: Insights from a Cross-Sectional Study

Background: Existing research reveals varied attitudes towards organ donation in the Middle East. This study specifically investigates public opinion on opt-out organ donation registration in Saudi Arabia, addressing a research gap identified through comparative studies in Qatar and Saudi Arabia. Methods: This study analyzed data from a cross-sectional survey conducted among 1,397 residents of Saudi Arabia. The questionnaire, adapted from a previous study in Qatar, included three sections to gather socio-demographic information, assess general awareness about organ donation, and explore participants' agreement with opt-out consent along with their beliefs related to organ donation using the Theory of Planned Behaviour (TPB) model. Statistical methods were employed to determine significant associations and trends. Results: Among the participants, nearly half (44.4%) supported opt-out consent, with women and Saudi citizens showing considerable support at 25.7% and 39.1% respectively. Women and individuals with diploma/graduation-level education were significantly more likely to support opt-out (p<0.001 and p=0.012, respectively). Of the opt-out supporters, a vast majority were familiar with organ donation (98.06%), willing to promote it (93.05%), and believed that registration saves lives (98.38%). Furthermore, 86.75% expressed readiness to support with more information, and 85.78% if informed about their religion's perspective on donation. A large proportion believed that both living and posthumous donations positively impact life after death (92.25%). However, concerns were raised about inadequate care (33.44%) and bodily disfigurement (28.43%) post-mortem. Most felt healthy enough to donate (45.56%) and appropriate in age (57.67%). Conclusion: The study reveals considerable openness among Saudis toward an opt-out organ donation system, suggesting a potential avenue for significantly increasing organ donation rates. While acknowledging cultural and familial influences, targeted interventions are vital to address specific barriers such as concerns about post-mortem care and bodily integrity. Implementing informed policies based on these insights could facilitate the successful adoption of an opt-out policy, enhancing organ donation rates in the region.