Alice Moseley, Graham Smith & Gerry StokerDepartment of Politics & International Relations University of Southampton, Rediscovering the Civic Project, Universities of Manchester & Southampton

UK Surveys report 65%-90% in favour of donating

their organs (New et al 2004)

Yet only 26% on ODR (NHSBT, 2009)

8000 people waiting for a transplant

1000 people died waiting in 07/08

50% more organs are needed

Gradual increase in donors but gap between supply

and demand growing faster (8% per year) (DH, 2008)

Repertoire of policy tools based around behavioural

economics principles (Thaler & Sunstein, 2008)

Heuristics: Cognitive limitations so shortcuts, rules of

thumb, eg following the herd or status quo

Loss aversion: We care more about losses than potential

gains

Hyperbolic discounting: Calculations that are in our

short term but not our long terms interests – ‘Buy now, pay

later!’

Yet preferences are constructed not fixed so amenable to

govt influence

Govts use nudges to encourage behavioural change (by

taking on role of ‘choice architect’)

Eg Changing defaults: recognises status quo bias within

decision-making

Eg Information provision: Enabling people to make more

informed choices

Organ Donation…. From informed consent to

presumed consent? Or mandated choice? Changing

defaults

Information nudges

Rather than nudging citizens, government

merely provides opportunities for them to think

Deliberation, dialogue, debate, peer education

Deliberative turn in democratic theory &

practice

Focus on collective rather than individual

behaviour Organ Donation…. Educative effect of discussing and debating.. Lack of awareness one of biggest obstacles…

Research Qs How effective is information provision

alone compared to information & deliberation for increasing ODR?

How does information and deliberation affect attitudes towards ODR?

Methodology Post-test only RCT amongst HE students Data collection via survey administered in

lecture theatres

Control group: Questionnaire only

Treatment Group A: Information + (NUDGE) Questionnaire

Treatment Group B: Information + Dialogue (NUDGE & THINK) + Questionnaire

Control Group Treatment ATreatment B

Step 1 Introduction Introduction Introduction 5 min

Step 2 Questionnaire Read info pack Read info pack15min

Step 3 Leave hall Watch video Watch video 10min

Step 4 Questionnaire Group discussions 15min

Step 5 Leave hall Questionnaire 15min

Step 6 Leave hall Tot:60min

Dependent on gatekeepers

Permission to link study to actual

registration

Non-attendance

Student sample: external validity

Fresher’s Fair contamination

Research Qs How do informed consent (opt in), presumed

consent (opt out) and mandated choice questions impact on ODR?

How acceptable do participants find these alternative systems?

Methodology Post test only RCT amongst HE students Data collected via online survey

Group 1: INFORMED CONSENT/ OPT IN (Status quo)

Group 2: PRESUMED CONSENT/(NUDGE 1) OPT OUT (Alternative A)Group 3: FORCED CHOICE (NUDGE 2) (Alternative B)

Group 1: Please register my name on the National Organ Donor Register

Group 2: Please register my name on the National Organ Donor Register (uncheck the box if you DO NOT want to register your name)

Group 3: Please register my name on the National Organ Donor Register

Yes No

Permission to link study to actual registration:

will provide opp. to retrospectively re-register

Student sample: external validity

Dealing with non-response/ self-selection bias

May not be possible to include all students:

again dependent on gatekeepers