For years, health policymakers have struggled with reconciling a gap (real or perceived) between people who voice public support for organ donation (90.4%) and those who actually agree to serve as organ donors (49.9%). In this policy space, two main organ donor approaches dominate ("yes/no" and "opt-in") and for years researchers have wondered "whether how individuals are asked to become organ donors might impact registration rates." Prevailing wisdom largely implies that because "the opt-in frame emphasizes that the default is not being a donor, which individuals might construe as an implicit recommendation of policymakers." Thus, as states moved from an "opt-in" to a "yes/no" approach to potential organ donors, researchers began to assess, primarily through survey experiments, whether "the yes/no question frame actually increase organ donor registrations."
In a recent paper, Increasing Organ Donor Registration as a Means to Increase Transplantation: An Experiment with Actual Organ Donor Registrations, the authors, Judd B. Kessler (Penn-Wharton) & Alvin E. Roth (Stanford--econ.), lever a “field-in-the-lab” research design and find, in contrast with data drawn from hypothetical donation decision experiments, no statistical difference between the two competing donor approaches. The paper's excerpt follows.
"The United States has a severe shortage of organs for transplant. Recently—inspired by research based on hypothetical choices—jurisdictions have tried to increase organ donor registrations by changing how the registration question is asked. We evaluate these changes with a novel “field-in-the-lab” experiment, in which subjects change their real organ donor status, and with new donor registration data collected from US states. A “yes/no” frame is not more effective than an “opt-in” frame, contradicting conclusions based on hypothetical choices, but other question wording can matter, and asking individuals to reconsider their donor status increases registrations."
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