With most respondents as medical students, 72.5% of them showed positive attitudes about organ donation. This can be attributed to their medical background, which facilitates a better understanding of medical ethics and transplantation [13]. Meanwhile, 27.5 % of students showed refused to participate which is an indication of the fact that issues related to bodily integrity and post-mortem donation are more influenced by the cultural and religious beliefs. These factors can therefore provide insight into the generally moderate approach that university students take toward organ donation [14]. Other factors deterring potential donors include misinformation about the distribution of organs, ethical concerns, and fears about the removal of organs too early [15]. Limited personal experience with organ donation, particularly among younger students, relates to lower degrees of support. Without direct access to transplanting events, students may be less likely to view organ donation in a favorable light [16].

Moreover, the findings showed that university students possess a moderate attitude towards organ donation, with a mean score of 56.05 out of 80, with a SD = 9.11. Nearly half of the students exhibited a moderate attitude (45.5%), whereas 27.5% displayed low attitudes and 27.0% high attitudes. The findings indicate a nuanced perspective on organ donation, with a considerable number of students holding reservations even while acknowledging its potential to save lives [17]. Several studies in the UK [18] Syria [19] and Jordan [10,20,21,]similarly identified cultural, ethical, and personal factors influencing attitudes toward organ donation, which also in line with the findings of our study.

The strong positive responses in the attitude to life view area indicate a belief that significant numbers of students value the humanitarian and saving-lives aspects attributed to organ donation. However, the residual apprehensions concerning funerals and feelings of unnaturalness of donations imply deep-seated social fears. Ambiguity about body integrity after death is likely to muddy these confusions [22]. All this reluctance in having frank discussions about death further limits proactive organ donation, hence perpetuating existing misconceptions. Misconceptions about brain death, in addition to burial customs and bodily integrity, are greatly shaped by cultural and religious views toward organ donation in Jordan [20]. A previous study has shown high levels of awareness but miscommunication and mistrust leading to low acceptance of donations within the healthcare system. In addition, Lack of organized instruction and truthful communication about death helps reinforce such misconceptions [10]. Addressing These barriers would greatly increase public acceptance of organ donation through focused information campaigns and religious debate.

Emphasizing the critical impact of family and societal expectations in shaping students’ perceptions, the attitude of family value domain obtained the lowest score. That students expressed concerns regarding family rejection is consistent with Jordanian cultural norms where familial consensus often informs medical decisions. Very often, organ donation is considered a decision more appropriately left to older individuals, a mindset that makes younger individuals reluctant.

Social taboos in general regarding dying and bodily integrity might hinder discussions on post-mortem organ donation, leaving the students uncertain if this decision will be acceptable for their family. The management of such uncertainty, on the other hand, may require culturally correct information campaigns where religious opinions regarding organ donation support it, including family discussions. Studies in Jordan confirm that familial and social expectations play an important role in organ donation attitude, and concern about family disapproval and a lack of awareness are major obstacles [10,20]. These may be improved by culturally sensitive awareness initiatives that can increase acceptance and donor registration.

Apart from this, the attitude of distrust of the domain of evaluation reflects latent mistrust in the attitude of the healthcare system regarding the ethical issues of transplantation and organ allocation. Concerns over early removal and its risks to recipients indicate uninformed publics about medical practices that ensure the moral procurement of organs. Past instances of medical negligence or information disparities could enhance distrust and subsequently raise concerns over donation surgery. The need for ethics development along with publicity and the sharing of truthful information related to the selection criteria and methods behind organ allocation will go toward erasing doubts and increasing public faith in the medical fraternity. previous studies in US [23] and Jordan [10,12,21,22] highlight mistrust in the healthcare system, misconceptions about brain death, and ethical issues as significant barriers to organ donation. Indeed, targeted education, transparency in organ allocation, and policy changes could help build public confidence in donation programs.

According to the demographic study, attitudes toward organ donation varied greatly with respect to marital status and age, being more positive among married and older students. Better attitudes among married students could be related to greater exposure to health-related topics in family contexts when the responsibility of making medical decisions becomes clearer. Similarly, the favorable attitudes of the students 26 years of age and above hint at the reality that life experience and maturity improve one’s abilities to understand all the ethical and medical implications involved in organ donation. Younger students, not having had time to experience and directly interact as much with the health problems themselves or ethical questions, are thus more likely to have moderate and negative sentiments. As clarified by many studies, it was confirmed that older and married participants have more positive attitudes toward organ donation due to more life experience and exposure to medical decision-making [25,26]. Yet, cultural moderators might occur that could explain the non-significant correlation between these variables in Iran [27].

The clearest correlation was between attitude scores and willingness to donate; students willing to donate had distinctly more favorable views of organ donation. This finding underlines the closeness of the link between general attitude and personal commitment, hence supporting the need for interventions enhancing willingness through targeted education and exposure to real-life donating situations. Organ donation awareness programs with stories of donors and recipients may help in bridging the gap between conceptual willingness to donate and actual willingness to donate. Research indicates that the propensity to donate is significantly associated with positive attitudes, whereas focused instruction, exposure to actual donations, and previous giving experiences augment donation intentions [20,28,29,30].

The prediction model confirmed that age and willingness to contribute were the most important variables, and taken together, they accounted for 16.0% of variance in opinions. Although readiness to donate came up as the strongest predictor, the relatively low R-squared value reflects that other factor such as religious beliefs, personal experience with organ donation cases, and trust in the health system play very important roles in shaping views. The absence of married status from the final model indicates that its effect is mediated through the other factors and, thus, reinforcing the hypothesis that greater social and personal events define attitudes more than demographic traits alone. Religious beliefs, cultural norms, awareness, and family influences are indeed overwhelming factors in studies of attitudes towards organ donation, often more significant than demographic ones like age and willingness to donate [31,32].

Public policy and health interventions are deeply dependent on these findings. These campaigns must then be designed in a way to target concerns among the young and the unwilling donor, since willingness to donate and age are foremost indicators. The modification of attitude might be mostly dependent on public discussion of the ethical harvesting of organs, social support from relatives, and religious support for organ donation. Moreover, building trust in the healthcare system through more equitable organ allocation policies and ethical safeguards will minimize uncertainty.

This research underlines, above all, the necessity of targeted, culture-specific educational interventions to alter Jordanians’ attitudes towards organ donation. Through structured awareness campaigns, family rejection issues, ethical conduct, and medical trust could be substantially increased levels of acceptance and willingness to donate. More profound psychological and social attitude determinants need to be investigated in subsequent research to develop more comprehensive policies for enhancing wider public participation in organ donation programs.

Targeted policy changes will help to better improve organ donation rates in Jordan. This would include adding organ donation awareness into the core of medical and health-related courses, enabling the understanding and clarification of misconceptions early, while building positive attitudes, this recommendation aligns with multiple studies [33,34,35]. Additionally, this would make it easier for individuals to register as donors through a national registry led by the Ministry of Health, whereas religious concerns and ignorance curtail public participation in Jordan, national donor registries around the world, as seen in Spain and the Saudi Arabia [36], where easy registration procedures facilitate participation, have increased organ donation rates. Clearly targeted policy measures are needed in Jordan, even with the electronic donor register that the Ministry of Health maintains. Thirdly, improved transparency in organ allocation via open regulatory frameworks and publicity mechanisms will eliminate public mistrust and give them confidence in the healthcare system [37]. Similarly, culturally sensitive media campaigns with the help of religious and community leaders are going to lead to education on Islamic perspectives of organ donation, thus facilitating discussions among families [38]. Finally, legal and financial security for the donor families may include covering burial expenses or other benefits [39].