The sup­ply of organs suit­able for dona­tion is vastly smaller than the demand. To try and increase the pool of poten­tial donors a num­ber of options have been tested:

Redefin­ing death so ‘liv­ing’ organs can be taken from donors who have died through brain death (via Link Banana), pro­vide incen­tives for poten­tial donors, or employ choice archi­tec­ture to get the results you want.

On the lat­ter (the choice archi­tec­ture option), Tim Har­ford pro­vides a con­cise look at the rise of soft pater­nal­ism in pol­i­tics and why we should be cau­tious:

For a busi­ness, the choice is not straight­for­ward, even if the aim – to max­imise profit with­out alien­at­ing cus­tomers – is sim­ple. For a gov­ern­ment, the deci­sion should be harder still. Gold­stein points out that 12 per cent of Ger­mans and 99.98 per cent of Aus­tri­ans are reg­is­tered organ donors. Ger­mans have to opt in to the donor scheme, Aus­tri­ans have to opt out. The impli­ca­tion: few peo­ple really have a strong pref­er­ence as to whether to be an organ donor or not, so they stay where they’re put.

The response to this is not obvi­ous. Per­haps the gov­ern­ment should use the default to max­imise organ dona­tions. A more cau­tious approach would be to try to fig­ure out what peo­ple would pre­fer if they could be per­suaded to give it some proper thought. One indi­ca­tion comes from research by Gold­stein and Eric John­son: in an exper­i­ment on organ dona­tion, peo­ple forced to choose one way or the other acted like peo­ple who were placed in the donor pool by default. In this par­tic­u­lar case, max­imis­ing the donor pool and doing what peo­ple really want seems to be much the same thing. Other cases will be less clear-cut.