This study surveyed 800 students in the United States, Hong Kong, and Japan to determine associations between the components of the theory of reasoned action and early communication about organ-donation decisions within the family. Results showed that among the 3 ethnic groups, Japanese students reported the least favorable attitudes and subjective norms about organ donation and were also the least likely to discuss this topic with their families. Moreover, the moderating effect of ethnicity indicated that attitudes were a significant factor of family discussion among American and Japanese students but not among Chinese students. Subjective norms were more predictive of family discussion among Chinese students than among American and Japanese students.