This research aims to Recognizing the concept of kidney and liver failure and its diagnosis, the criteria for kidney and liver donation, and the importance of organ donation. Identify the medical, ethical, personal, and emotional dimensions that contribute to patients' refusal to accept organ donation, Explaining the psychological factors of patients and their families affecting the decision to donate, and the role of social workers, psychiatrists, and the health system's roles in the donation process. Where in the realm of organ transplantation, a critical ethical issue emerges when patients diagnosed with kidney or liver failure reject potential donations from their relatives. Therefore, through this study we will explore the underlying reasons behind kidney and liver failure patients’ refusal to accept organ donations from their relatives. By delving into the motives and circumstances surrounding this decision, through a cross-sectional study of a sample of respondents, patients who have declined familial organ donations, as well as their family members, healthcare providers, and the general public, Through a cross-sectional study of a sample of 2,348 respondents, patients who have declined familial organ donations, as well as their family members, healthcare providers, and the general public In the Kingdom of Saudi Arabia during the year 2024. Thematic analysis will be employed to identify recurring themes and patterns in participants’ narratives, elucidating the motivations, concerns, contextual and factors influencing the decision-making process. Ethical considerations will be rigorously addressed throughout the research, ensuring confidentiality, informed consent, and sensitivity to participants’ autonomy. The study will provide useful findings and recommendations to the community, healthcare providers and decision makers.