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Professor Ivo Vlaev comments on the behavioural science behind opt-out organ donation

vlaevProfessor Ivo Vlaev, of Warwick Business School, is a Professor of Behavioural Science and has advised local and national policymakers on how to use behavioural science insights - nudges - in their policy setting.

Commenting on the annoucement that the UK government will consult on changing the organ donation register to an opt-out system, he said: "Policies that change the context or ‘nudge’ people in particular directions have captured the imagination of policymakers at the same time as the limitations of traditional approaches have become apparent.

"One such nudge technique is known as 'defaults' which is based on evidence that we automatically tend to ‘go with the flow’ of pre-set options. Defaults are choice options that are assumed as pre-selected if the individual does not make an active choice of another available alternative. Many of us will be aware of our tendency to stick with the pre-set option and that is why defaults are so powerful.

"A number of studies have shown that behaviour on both the provider and public side can be dramatically influenced by the default setting.

"Techniques that change defaults have been very successfully used to change behaviours in various settings. Defaults have been mostly used in interventions changing financial behaviours, when the default is to automatically enrol employees in their pension plan, about three-quarters tend to retain both the default contribution rate and the default asset allocation.

"The use of defaults for presumed consent for organ donation is controversial, but Austria, France, Poland, and Portugal have such a system and as a result 90–100% of their citizens are registered donors, compared to only 5–30% in countries that do not use the donor default strategy.

"Although over 80% of people when surveyed say they would like to be on the register – only about 20% are. Why? After all they only need to sign a card but that action can be too much for some. In countries with an opt-out policy – that is everyone is on the register – it is seen that the vast majority remain on the register. It was estimated that moving to an-opt out system would increase effective donation rates by 50%.

"In a study Eric Johnson and Daniel Goldstein found that when donation is the default there is a 16.3% increase in donations, while another study reported an increase of 56.5%. So, the evidence so far is pretty convincing."

12 December 2017

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