Choice Architecture of Organ Donation

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.

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