2005 National Survey of Organ and Tissue Donation Attitudes and Behaviors

Conducted and Prepared by The Gallup Organization for
Division of Transplantation
Health Resources and Services Administration

Executive Summary

The 2005 National Public Opinion Survey on Organ Donation is a representative sample of more than 2,000 Americans concerning their attitudes toward donation of organs and tissues for transplantation, donation discussions with family, permission to donate, beliefs about donation, and opinions on policies related to donation. The 2005 study replicates an earlier survey completed in 1993 by The Gallup Organization for the Partnership for Organ Donation and includes some new items as well.

As in 1993, Americans continue to strongly support the concept of donating organs or tissues for transplantation. The proportion of survey respondents who said they support or strongly support organ donation rose from 93% in 1993 to 95% in 2005. The proportion of respondents who said they would be “likely” or “very likely” to have their organs donated after their death rose over this period. In 1993, 73% said they would be likely or very likely to have their organs donated whereas in 2005 the percentage had risen to 78%. About four in five Whites (82%) indicated they were likely or very likely to donate their organs; about three-fourths of Latinos (75%), three-fourths (75%) of Asians, and three-fifths (64%) of Blacks indicated they were likely or very likely to donate their organs.

Survey results show that 52.7% of Americans have granted permission for donation of organs or tissues on a driver’s license or an organ donor card. This represents a significant increase since 1993 when only 28% had granted permission for donation on a driver’s license or an organ donor card. Respondents who had not yet granted permission for donation were asked if they were willing to do so. Nineteen percent (19%) said they were willing. This figure was higher (28%) in 1993. It is likely that the number willing was less in 2005 than in 1993 because many of those who were willing in 1993 had granted permission by 2005. All told, in 1993, 55% of Americans had granted permission to donate or were willing to do it; by 2005, this proportion had risen significantly to 72%. In 2005, Whites (61%) were most likely to grant permission to donate on their driver’s license, with Blacks (31%) least likely, and Latinos (39%) and Asians (39%) in between.

Nearly all the survey respondents (97%) said they would donate a family member’s organs if the family member’s wishes were known. This is only a slight increase over 1993. However, in 2005 (71%) significantly more people than in 1993 (47%) would donate a family member’s organs when they did not know the family members wishes.

During the past several years, the transplantation community has been involved in a campaign to motivate people to talk to family members about their organ and tissue donation wishes. Between 1993 and 2005, there have been important increases in the proportion of survey respondents who report that they have told a family member about their wish to donate their organs or tissues or that a family member has told the respondent about his/her wishes. In 2005, 71% of Americans had told a family member about their wishes regarding donation. In 1993, this proportion was only 52%. Similarly, in 2005, 53% of Americans reported that a family member had communicated their wishes about donation, whereas in 1993, this proportion had been 29%.

Some new questions added to the 2005 survey pertain to living donation, that is, donating an organ such as a kidney while one is still living. About three in five Americans (62%) would be very likely to serve as a living donor for a family member. This is in contrast to 31% who would be very likely to make a living donation for a close friend, or 8% who would be very likely to make a living donation for someone they don’t know.

A number of proposals have been put forward to dramatically increase organ and tissue donation in the United States. One proposal has been to provide financial incentives to donors or their families. In the United States today, 16.5% of the population say that they would be “more likely” to donate their own organs if paid an incentive, though most (72.2%) say a financial incentive would have no effect on their decision. A similar proportion (18.7%) say that they would be “more likely” to donate a family member’s organs if paid an incentive. These proportions have increased from 1993 to 2005. In 1993, 12.0% of Americans reported that an incentive would increase the likelihood of donating their own organs and 12.0% also indicated that an incentive would increase the likelihood of donating a family member’s organs.

Another proposal to increase rates of organ and tissue donation is presumed consent. This is an opt-out system in which everyone is considered to be a donor unless they take appropriate steps to declare themselves a nondonor. In all, support is not strong for changing to a presumed consent system for the United States. Together, those who “strongly support” presumed consent (15.1%) and those who “support” it (28.1%) comprise less than half the population. Most people either “oppose” (26.7%) or “strongly oppose” (30.1%) presumed consent. The lack of widespread support is not for want of perceived effectiveness. Fully 85.9% of respondents believe that a system of presumed consent would increase the number of available organs for transplant. About three in ten Americans report that they would opt-out of a presumed consent approach.

What people believe about donation influences their willingness to donate and/or to indicate their permission to donate on a driver’s license, donor card, or registry. Some beliefs that deter individuals from donating organs are based upon misinformation. Organ procurement organizations and others attempt to counteract misinformation through public education.

Beliefs based on correct information are associated with a greater likelihood of organ donation. Changing beliefs that have a high impact on donation but are based upon misinformation provides a valuable opportunity for increasing willingness to donate and actual donation. For example, if someone believes that “organ and tissue donation can often transmit diseases, such as HIV, hepatitis, or West Nile virus,” then that person will be less likely to donate. Given that 52% of the population somewhat or strongly believes this statement, then there is an opportunity to change the minds of a large number of people on this belief.

Other beliefs, if more commonly held within the population, also seem likely to increase donation. These include the belief that most of one's family members support donation, that organ donation helps surviving family members cope with their grief, that given equal need, a poor person has as good a chance as a rich person of getting an organ transplant, and that the national transplant system, monitored by the Federal government, provides equitable access to transplantation. It also is expected that increases in overall donation would occur by eliminating the belief that families of organ donors end up paying extra medical bills, and the belief that it is possible for a brain-dead person to recover from his or her injuries.

COPYRIGHT STANDARDS

Many of the items used in the survey questionnaire for this study are proprietary content owned by The Gallup Organization and may not be used without permission. The items owned by The Gallup Organization are items #1, #2A, #2B, #2C, #2F, #2H, #2K, #2L, #2M, #2N, #2S, #4, #5, #6b, #6c, #7, #8, #9, #10, #11, #12A, #12B, #12C, #12D, #12E, #13, #14b, #16A, #16B, #16C, #16D, #16E, #16F, #18, #22A, #22B, #22C, #22D, #22E, and #22F. Copyright © 1993, 20052006 The Gallup Organization, Washington, D.C. All rights reserved.