The goal of this study was to evaluate rates of family refusal for organ donation in three U.S. cities (New York, Los Angeles, and Miami) in order to compare these rates among whites, African Americans and Latinos.

Data for this study were collected from regional transplant programs for the period from January 1984 to April 1987 and included information on the number of patients on waiting lists, the number of cadaver transplant recipients, the number of cadaver organ donors, and the number of eligible families who refused consent for organ donation.

There were substantial regional differences in the family refusal rate: 42% in NYC, 26% in LA and 21% in Miami. “This agrees with reports that more centralized organ procurement agencies such as those in Miami and LA function more efficiently than those that were not centralized until recently, such as those in NYC…”. Across the three cities, both black and Latino refusal rates were higher than the rate in the white population. In the three cities combined, 45% of the black, 43% of the Latino and 17% of the white potential donors refused.

The only reason discussed for the difference between white and black family refusal rates was that “blacks and Latinos have lower levels of educational, financial and health status than whites.”

With regard to the reasons for the Latino refusal rate, the authors argue that since some Latino populations are more similar to whites with regard to educational and financial indices and there were no differences in family refusal rates across the cities studies, other factors must be important. As possibilities, they suggest a language barrier, the desire for agreement among extended family members, religion, and myth and superstition.