In Italy, in the first three months of 2025, 40 percent of the 950 thousand people who renewed their identity card opposed the organ donation. An alarming figure that risks compromising the future of the national transplant system despite the progress achieved in recent years. Our country, in fact, continues to record excellent numbers in terms of actual donors and transplants performed. But the oppositions increase, especially in the South, and the waiting lists remain dramatically long.

Behind that “no”, often, there are no true ethical or religious motivations, but a toxic mixture of fears, disinformation and fake news. Let’s see the four most common beliefs.

The body as a fetish to be preserved

The most frequent motivation between those who refuse the donation concerns the integrity of the body after death. “I want to be buried whole”, “I don’t want me to cut myself”, “I’m afraid of being in pieces”: they are real phrases collected by health workers. An ancient cultural heritage, amplified today by the widespread fear of death and the collective inability to talk about it. The body becomes a fetish to be preserved, even when it no longer has life. But transplants are performed with absolute respect for the human body and do not prevent vision or the funeral rite, as many mistakenly believe.

Distrust in the doctor who ascertains the death

One of the hardest fake news to die is that according to which a donor patient would not receive adequate care in case of emergency, because “it is better to use its organs than to save him”. It is a dangerous lie. In Italy, the assessment of brain death is rigidly regulated by law. Three specialists: resuscitator, neurologist and coroner certify, independently and repeatedly, the patient’s death. Only after this process, and never before, can we proceed to the donation. To think that a doctor puts interest in an organ to life is not only false, but also offensive for a profession that fights every day against death.

The false conflict between religion and donation

Another hard myth to die is “my religion does not allow it”. In reality, all the great monotheistic religions – Catholicism, Judaism, Islam – have expressed favorable opinions to the donation of organs considering it an act of love towards others. Pope John Paul II, already in 2000, defined the donation as “an authentic gesture of love”. Yet popular perception often distort these messages, fueling unfounded doubts and unjustified waste.

The suspicion towards the system

“What if the organs go to who has more money?”, “Who guarantees me that the system is transparent?”. There are legitimate doubts but the answers exist: the regional centers and the National Transplant Center follow very rigid criteria for the assignment of the bodies, based on urgency, compatibility and time on the waiting list.

Then there is a category often forgotten, but numerically relevant, which weighs almost as much as explicit oppositions: the abstentions. They are those who, despite having had the opportunity, have not expressed any will on organ donation. No yes, but not even a no. Only silence.

The silence that becomes a no

In Italy, in case of non -declaration, the law entrusts the decision to family members, often in a tragic and confused moment, when lucidity is clouded by pain. The paradox is that many abstentions, in a less emotional context, would say favorable. But they have never found the time, belief or right information to record that choice. Thus, in doubt, consent is often denied.

The consequence? Potential donors who, by omission, never become it. The culture of donation is built over time, not in the ten minutes to the registry and must start from the school that introduces these themes already from adolescence.

What to do?

Expressing one’s will in life is simple. You can do it at the time of the renewal of the identity card, registering online on the website of the National Transplant Center or through Aido. And above all, you can talk about it in the family. Because in case of sudden death, the decision is up to relatives. Knowing what he would have liked who is no longer there, he can make the difference between a no and a yes that saves a life.

The “no” to the donation is often only a response dictated by fear. Knowledge, however, can transform that fear into a gesture of generosity capable of giving hope to those who are waiting.