Concern about the grief processes of organ donors' families are reported by medical staff as a reason not to ask for organ donation. Objectives of the current study were to examine the relation between consenting to a post-mortem organ donation procedure and subsequent process of grief in the bereaved. A cross-section survey was conducted in a representative time-sample of 95 bereaved who lost a first-degree family member on intensive care wards in 27 Dutch hospitals. In 36 cases an organ donation procedure took place, in 23 cases consent was refused and in 36 cases no request for organ donation was made to the bereaved. The authors found there were no differences in levels of depression and problems with detachment from the deceased between bereaved (first-degree family members) who participated in an organ donation procedure, those who refused consent, and families who were not approached for poet-mortem organ donation. No differences were found in levels of main outcome measures between three donation conditions. However, dissatisfaction with hospital care was associated with depressive and grief symptoms. The results indicate that consenting to organ donation in itself neither hinders nor furthers the grief process.