Improving the consent rate for solid organ donation from deceased donors is a key component of strategies in the UK and other countries to increase the availability of organs for transplantation. In the UK, the law is currently clear on what forms consent may take, with the views of the individual expressed previously in life taking priority. Such views may have been expressed prospectively, via membership of the Organ Donor Register or by talking to family members. The factors determining such actions include both positive altruistic motives and negative psychological responses. Studies have examined why some families of potential donors refuse consent, while others have demonstrated a key set of 'modifiable' factors relating to the family approach. These include ensuring the right timing of a request in an appropriate setting, providing emotional support, and imparting specific information, particularly concerning the nature of brain death. If these are optimized and the right personnel with adequate training are involved in a planned process, then consent rates may be improved as reported in other countries with organized donation systems.