2005 National Survey of Organ and Tissue Donation Attitudes and Behaviors

3.2 Organ Donation Behaviors

This section examines survey results for questions describing respondent behaviors. The first set of behaviors consists of granting permission to donate one’s organs on a driver’s license, a donor card, or a donor registry. The second section describes discussing organ donation with family members.

3.2.1 Granting Permission to Donate Organs and Tissues

Have you granted permission for organ and tissue donation (On your driver’s license/On a signed donor card/By joining an organ donor registry)?

Figure 4 shows that 52.1% of Americans have granted permission for donation on a driver’s license. Another 30.9% have signed a donor card and 17.6% have joined a donor registry. However, the overlap among these categories is nearly complete. Only slightly more than 1% of respondents who have signed a donor card or joined a registry have not also granted permission on their driver’s licenses. Thus, compare the 53.2% who report all three with the 52.1% who report granting permission on their driver’s license only. Therefore, most of the comments about granting permission to donate will be limited to doing so on a driver’s license.

Figure 4. Granting Permission for Organ and Tissue Donation, 2005

Table 3 reports that almost 80% of respondents believe that granting permission on their licenses register them to become donors. This likely means that they believe their wishes can be determined by hospital personnel and their wishes will be observed.

Would you be willing to grant permission for organ and tissue donation on your driver’s license, on a donor card, or by joining an organ donor registry?

Over two-fifths (43.2%) of those who have not granted permission for donation report that they are willing to do so. This means that about 20% of the U.S. population has not granted permission for donation, but indicate they would.

Figure 5 shows how granting permission and willingness to grant permission for organ donation on the driver’s license or a donor card has changed over time. Over the intervening years, the number of persons reporting that they have granted permission to donate on a driver’s license or donor card has increased from 28% to 53.2%, nearly double. Some of those granting permission must have come from persons who in the past would not even have contemplated a willingness to donate, as the willing category could not have supplied the entire increase.

Figure 5. Granting Permission and Willingness to Grant Permission for Organ and Tissue Donation, 1993–2005*

As shown in Table 3A, women and men are about equally likely to grant permission to donate organs and tissues on their driver’s licenses. As with support for donation and reported likelihood of donation, those aged 35 to 54 are most likely to grant permission to donate. However, race and education are strongly related to granting permission to donate on the driver’s license.

Table 3A. Granting Permission to Donate Organs and Tissues by Gender, Age, Race/Ethnicity, and Education
Results in percentages

Table 3B. Likelihood of Organ and Tissue Donation by Race/Ethnicity and by Education
Results in percentages

Figure 6 shows that Whites (60.5%) are much more likely than Blacks (31.2%), Latinos (39.3%), or Asians (38.6%) to have granted permission to donate on their driver’s licenses. Similarly, those who are college graduates or higher (63.8%) or with some college (55.1%) are significantly more likely to grant permission to donate than those with a high school diploma or less education (28.6%).

Those who had not granted permission for organ donation were asked how willing they would be to grant permission for organ and tissue donation on their driver’s licenses, on donor cards, or by joining organ donor registries. Men are somewhat more likely to say they were willing (47.6%) than are women (39.6%). Also, those in the youngest age group expressed greater willingness to be a donor. Among those aged 18 to 34, 50.6% expressed willingness to donate compared with 44.4% of those aged 35 to 54 and 37.4% among those 55 and older.

Figure 6. Granting Permission for Organ Donation on the Driver’s License by Race/Ethnicity and Education, 2005

Willingness to donate is high among Latinos (49.2%), Asians (46.0%), and Whites (44.8%), but is significantly lower among Blacks (30.0%). An estimate of the proportion of the population approachable for donation can be determined by multiplying the proportion willing to donate times the proportion of those who haven’t granted permission to donate. Using this approach, one finds that 28.1% of Latinos haven’t granted permission to donate, yet are willing to do so. Almost as great a proportion of Asians (26.2%) fall into this category, but fewer Blacks (19.8%) or Whites (16.9%) do.

Willingness to donate is highest among college graduates or higher (52.3%). In contrast, 27.2% of those with a high school diploma or less, 15.7% of those with some college, and 17.1% of those with a college degree or higher haven’t granted permission to donate, but are willing to do so. These persons may lack means or face obstacles to donation, but they don’t lack willingness.

Table 3B and Figure 7show the results for how likely one is to have organs donated after their death by both education and race. These results show that for the most part, Whites and Latinos are similar at all levels of education although they diverge somewhat at the college graduate level. Among Blacks, the likelihood of donating is considerably lower among those with only a high school education or less, but it is similar to that of other races others among college graduates. The results for Asians are irregular, which is probably a function of quite small numbers of Asians in the lower education groups.

Figure 7. Likelihood of Donation by Race by Education

3.2.2 Donating Family Members’Organs and Discussing Donation With Family

There has been a major emphasis since the 1993 survey on encouraging people who have granted permission to donate or who are willing to donate their organs to discuss their wishes with their immediate families. Often, when a person dies, his or her wishes may not be immediately known to medical personnel and, if unknown to immediate family, the family members may be reluctant to consent. Even with first-person consent, family awareness of wishes makes the donation easier on everyone.

If you didn't know your family member’s wishes, how likely would you be to donate his or her organs and tissues upon his or her death, if it were up to you?

If a family member HAD REQUESTED that his or her organs and tissues be donated upon death, how likely would you be to donate his or her organs and tissues if it were up to you?

The wisdom of this policy is shown in the responses to the questions in Figure 8. Over 96% of respondents say that they would be “very likely” or “somewhat likely” to donate a family member’s organs and tissues if the family member had requested that his or her organs and tissues be donated upon death. In contrast, 71.2% say they would be “very likely” or “somewhat likely” to donate a family member’s organs and tissues if they didn't know the family member’s wishes.

Figure 8. Likelihood of Donating Family Member's Organs and Tissues When Wishes Are and Are Not Known, 1993–2005

Although there has been only a slight increase in the likelihood of donating a family member’s organs when his or her wishes are known (96.7% vs. 93.0%), there has been an important and significant increase in the likelihood of donating a family member's organs when his or her wishes aren't known (71.2% vs. 47.0%) — an increase of 24.2% of the American population willing to do so.

Have you discussed your wish to be an organ donor with a member of your family?

Have you discussed with a member of your family your wish NOT to donate your organs after your death?

Has any member of your family told you about his or her wish to donate or not to donate his or her organs or tissues after death?

How willing are you to discuss your wishes about organ and tissue donation with your family?

Figure 9 presents results for a series of questions about discussing donation wishes with one’s family. The figure shows that just over 70% (70.8%) of the population has discussed their wishes to be an organ donor with a member of their family. This is a significant increase over the 52.0% found in 1993. In contrast, only 32.6% of those not wishing to donate their organs have discussed this with a family member, little changed from a decade ago. Among persons who have not discussed their desire to be an organ donor with their families, almost all are willing to do so with 36.3% saying they are “very willing” and another 47.7% in the more reluctant “somewhat willing” category. Although a majority say that they have discussed their wishes with a family member, only about half (52.8%) say that a family member has discussed the family member’s own wishes. This too is a significant increase over 1993 (29.0%).

Figure 9. Discussion of Donation With Family Members

Table 4 shows that the likelihood of donating a family member's organs if the family member had requested it varies little between genders and is somewhat greater in the 35 to 54 age group than among the others. There is little variation by race/ethnicity, but education seems to be more strongly related to likelihood of donating a family member's organs. Those in the lowest education level are less inclined to be "very likely" to donate a family member's organs (73.5%), than those with some college (89.0%) or college graduates (92.0%).

Table 4. Discussing Donation With Family by Sex, Age, and Race/Ethnicity

Men (68.0%) are less likely than women (72.9%) to have discussed their wishes with a family member, and Blacks (48.4%), Latinos (58.1%), and Asians (50.7%) are much less likely to have done so than Whites (78.3%). Blacks are least likely to report (30.6%) that a family member has discussed donation with them.

Education is very strongly related to having discussed donation wishes with a family member. Among those with high school educations or less, 54.7% have done so, while 73.4% of those with some college and 76.6% of those with college educations or higher have done so. Those with more education are more likely to report (62.6%) that a family member has discussed donation with them.

Some of the items used in the survey questionnaire for this study are proprietary content owned by The Gallup Organization. A complete list is found on the Copyright page. Copyright © 1993, 2005 The Gallup Organization, Washington, D.C. All rights reserved.