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Organ donation might be a matter of how you're asked

September 04, 2012|By Mary MacVean
  • UCLA physician Hans Gritsch, right, prepares a donated organ for transplant.
UCLA physician Hans Gritsch, right, prepares a donated organ for transplant. (Spencer Weiner / Los Angeles…)

Take a look at your driver’s license. Does it have the little dot indicating you’re willing to donate your organs should the worst happen? Either way, researchers say there are public policy implications in how you decided.

If you were asked to sign up to donate, would you make the same decision as if you were asked to sign up to refuse to donate your organs?

Turns out that in Europe, some countries have opt-in programs – those in which a person must decide to become a donor. Others have opt-out programs – those in which a person must decide not to become a donor. In the first case, not 15% of people choose to donate, whereas in the opt-out countries, the figure is often above 90%.

That, the researchers say in a study published Tuesday in the PNAS, is because the kind of organ donation program gets people to think about the act of donating in very different ways. “We contend that different default policies influence the very meaning that people assign to the act of being an organ donor,” the researchers from Cornell and Stanford universities wrote.

The researchers note that there are likely several factors influencing the donor rates, including inertia. But they say also that people don’t always just take the easy way out.

Their research, conducted by surveying people in Europe and the U.S., shows that opting in to donate is akin to asking: “Do you want to put yourself forward as an exceptional altruist, someone who acts for the good of others under circumstances when only particularly virtuous fellow citizens are likely to follow suit?”

And opting out, they say, could be asking: “Do you want to stand out as an exceptional misanthrope, someone who fails to step forward to do one’s duty as most good citizens and community members do?”

The researchers also asked American participants to read about the Netherlands’ opt-in policy or Belgium’s opt-out policy and rate that policy along with other behaviors – paying taxes, voting or volunteering, for examples.

They found that the ratings made donating a much bigger decision when the policy was opt-in – almost as big as going on a hunger strike for a cause -- than when it was opt-out.

The meaning of each option is a question individuals can ponder – and perhaps change their organ donor status as a result.

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