• Corpus ID: 17635693

Organ Donors ( Not ) by Default ?

@inproceedings{Johnson2003OrganD,
  title={Organ Donors ( Not ) by Default ?},
  author={Eric J. Johnson and Daniel G. Goldstein},
  year={2003}
}

• Eric J. Johnson, D. Goldstein
• Published 2003
• Medicine

[100 words to be written] More people approve of organ donation than register to be donors. In the United States, a recent poll showed that 81% of Americans approve of organ donation. However, in the states with the highest donor signup rates (through the Motor Vehicle Administrations), only half this number elect to opt in to the donor registry. Given the high approval level, why the low registration rates? Another curious finding is that organ donation rates vary widely across geographies. Within the European Union, for example, rates vary from 11 to 32 donations per million people. However, as we will later show, these differences cannot be easily explained by differences in culture, religion, nationality, or medical infrastructure. What then drives organ donation rates? The answer to this question is of great importance: every year 20,000 people die worldwide waiting for organs. How can we reconcile the marked shortage of donations with both the generally favorable attitudes toward donation and the accompanying lack of action? How can we explain how neighboring countries, similar in many respects, have vastly different organ donation rates? In this report, we argue that the reasons for these observations lie at the interface between the psychology of decision-making, economics, and public policy. We focus on the idea that preferences, such as those to be a potential donor are constructed, that is, assembled when needed, are therefore materially influenced by the nature of the question(1-3). The laudable goal of increasing organ donation rates has attracted many proposed solutions: including the payment of donors (4, 5) , suggestions that organs should become public property upon death(6), or that there should even be a market for the organs of the deceased (7 , 8). And there are many calls for campaigns to change public attitudes(9). Each solution suggests a different diagnosis: that people are opposed to donation, require financial incentives to donate, or lack an understanding of the benefits of donation. In contrast, modern psychological theories of constructed preferences, argue that preferences simply are not yet articulated in the minds of those who have not been asked. (2, 10, 11). This stands in stark contrast to the idea, stemming from economics, 1 Eric J. Johnson is Co-Director, Columbia Center for the Decision Sciences, and the Norman Eig Professor of Business. Daniel Goldstein is Associate Director, Columbia Center for Decision Sciences.