Obtaining consent from families for organ donation is the most important element of a successful transplant programme. In a recent large study of donor and non-donor families, 57% of families were predisposed to donate, 17% were unsure, and 25% were not in favour.¹ The challenge is to secure consent from those people who are predisposed to donate, convert a substantial proportion of those who are unsure, and convert a smaller proportion of those who are initially not in favour. In the right circumstances this approach can achieve an 80% consent rate.