Between loss and learning: a qualitative interview study of donor family voices and institutional practices in whole-body donation for medical education in Türkiye

Abstract

In Türkiye, whole-body donation for medical education and research is legally permitted, yet family involvement is central to whether donation proceeds. Despite this, donor family experiences remain underexplored. This study aimed to explore how surviving family members experienced and interpreted whole-body donation within medical education. Methods: Semi-structured interviews were conducted with 21 family members of 14 donors whose bodies were donated to the anatomy departments of Ege University and Koç University (2020–2023). Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. Results: Three interrelated themes were identified. First, institutional trust was constructed primarily through interpersonal encounters rather than formal procedures. Second, donation emerged as an ongoing family process involving interpretation of donor intent, moral meaning-making, and, in some cases, advocacy. Third, closure was experienced as a fluid and uneven process shaped by disrupted burial practices, commemoration, and continuing bonds with the donor. Clear communication, logistical support, and symbolic recognition were perceived as supportive, whereas uncertainty increased emotional strain. Religious considerations functioned mainly as contextual background rather than primary decision drivers. Conclusions: Whole-body donation was experienced by families as a relational and ethically mediated process extending beyond first-person consent. Although donor registration initiates donation, family authorization and interpretation of donor intent remain decisive in practice. Family-centered institutional practices may strengthen trust, support closure, and support ethically grounded anatomy education. By centering donor family perspectives within a family-mediated consent context, this study offers evidence to inform donor-centered policy, communication practices, and the sustainable development of body donation programs.