Attitudes toward Organ Donation among Japanese American Older Adults: Implications from the Open-Ended Responses

Despite the removal of upper age limits for organ donation and registration, little research has addressed the underrepresentation of donors among Asian American older adults. Japanese Americans, the fastest aging minority group in the U.S. and considered the most acculturated and assimilated Asian subgroup, offer a unique perspective. Understanding their attitudes toward organ donation may provide valuable insights into strategies for increasing donor registration among older adults in Asian American communities.

Using a community survey dataset of Japanese American older adults focused on end-of-life issues, descriptive statistics were used to examine knowledge, preferences, and arrangements related to organ donation. Open-ended responses were analyzed using summative content analysis to explore the underlying reasons for reluctance to become organ donors.

The descriptive statistics revealed a behavioral incongruity. While most participants expressed favorable attitudes toward organ donation, few were registered donors at the time of the survey. Qualitative analysis of open-ended responses identified five thematic categories: self-directed ageism, level of willingness, lack of awareness and/or knowledge, influential cultural values, and issues related to the organ donation system. The most prominent barriers were age and illnesses, both of which are key components of internalized ageism.

The findings highlight the need for targeted public campaigns that emphasize the absence of age restrictions for organ donation. Such efforts could help engage multigenerational audiences and promote donor registration among Japanese American older adults and their families, ultimately contributing to increased representation of Asian Americans in the donor pool.