Nudging People to Donate Organs

Monday, April 7, 2008

Nearly nine in 10 Americans approve of organ donation. But less than one in three has signed up to be a donor after death.

In an analysis published in the journal Science, Columbia University researchers Eric J. Johnson and Daniel Goldstein looked at organ donation rates and found that they differ dramatically from country to country. In Austria, France, Hungary, Poland and Portugal, more than 99 percent of people consent to donate. In the United States, the consent rate is 28 percent. In the United Kingdom, it is 17 percent; in Germany, 12 percent.

Why the dramatic difference? Because countries such as France and Poland make organ donation the default choice. Others make not donating the default. Either way, most people go along with the default option.

"God made us lazy and busy and prone to inertia," said Richard Thaler, a behavioral economist at the University of Chicago, who argues that countries such as the United States might want to rethink their default policies on organ donation.

But rather than making organ donation the default choice, Thaler suggested creating a system that forces people to make a choice one way or the other.

"When you go to get your driver's license, you would be required to check one of two boxes," he said. "You will be nudged to make a choice, whereas under many [current] systems, you have to go out of your way to make a choice. Here, you can't duck it. You have to say I am in or out."

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