What system should we have for organ donation?
At the moment, I’m reading a very interesting book called “Nudge” which is all about what the authors – Richard H Thaler & Cass R Sunstein – call “choice architecture” or, put another way, how we can ‘nudge’ people into making the right decisions for themselves.
One chapter is all about organ donation and five systems are examined:
- Free market – citizens would be permitted to sell and buy organs as they wish
- Routine removal – the state has the right to use your organs when you die without asking anyone’s permission
- Explicit consent – you have to indicate specifically that you wish your organs to be used on your death
- Mandated choice – you are required to make a clear choice about whether you do or do not wish your organs to be used
- Presumed consent – your organs will be used unless you have made it clear that this is not what you wish
Many European countries use ‘presumed consent’, but the UK and the USA use ‘explicit consent’. Thaler & Sunstein recommend ‘mandated choice’ with a requirement to indicate a decision when renewing your driver’s licence. Actually I favour the default option ‘presumed consent’ which would significantly increase the rate of donation and save many more lives.
For as long as I can remember, I’ve carried a consent card . If you live in the UK and wish to register your willingness to be a donor, please go here.
October 19th, 2010 at 10:40 pm
I would tend to agree with you, but I know some people do not donate for religious reasons. Judaism, for example, has a sort of complicated position on organ donation: http://judaism.about.com/library/3_askrabbi_o/bl_simmons_organdonation.htm. I have always figured that I won’t need my organs when I die, so anyone who wants them can have them. I think each state handles it differently, but my state of GA allows you a substantial discount on your driver’s license renewal if you agree to be an organ donor, and your license stipulates that you are willing to donate organs.
October 20th, 2010 at 11:10 am
Dana, Georgia’s approach is a classic example of what Thaler & Sunstein would call a ‘nudge’.