Association between death attitudes and organ donation card possession among medical sciences students: a cross-sectional study

Attitudes towards death influence health-related decisions, including organ donation. Despite general support for organ donation, actual registration rates remain low, highlighting the gap between intention and behavior. This study investigated the association between death attitudes and organ donation card possession among medical sciences students in Iran. A cross-sectional analytical survey was conducted with 207 students selected through multistage random sampling. Death attitudes were assessed using the validated Persian version of the Death Attitude Questionnaire. Differences in subscale scores between students with and without donor cards were analyzed using independent-samples t-tests, and binary logistic regression was employed to identify independent predictors of card possession. Students holding an organ donation card demonstrated significantly higher scores on Acceptance and Constructiveness and lower scores on Fear and Anxiety and Neglect and Indifference compared to non-cardholders (p < 0.05). Logistic regression indicated that higher Acceptance and Constructiveness scores positively predicted card possession (B = 0.076, OR = 1.078, 95% CI: 1.004–1.158, p = 0.038), whereas higher Fear and Anxiety scores negatively predicted it (B = -0.110, OR = 0.896, 95% CI: 0.821–0.978, p = 0.014). Other death attitude dimensions and demographic variables were not significant predictors. Constructive acceptance of death facilitates organ donation behavior, whereas death-related fear acts as a barrier. Interventions promoting healthy confrontation with mortality and addressing existential and bodily concerns could enhance donor card registration among medical students and similar populations.