Do Default Options Save Lives?

Via Dan Ariely's contribution to this Freakonomics post yesterday, I was lead to a fascinating paper on default options and behavior. The results on organ donation in Europe are particularly striking, as the authors show that large differences in organ donation rates in otherwise similar European nations (e.g. Sweeden and Denmark) may in large part be a consequence of whether organ donation is an opt-in or opt-out option on the drivers license application.

As the authors note, there are substantial public policy implications to research along these lines. For example here in the U.S., there is a growing chorus of policy gurus, including at least one major presidential candidate, pushing for policies such automatic retirement accounts. The idea is that rather than enacting more blunt mechanisms (e.g. mandates), we can implement policies that harness the inertia brought about by default options to achieve policy goals.

Update: In comments, Kieran Healy raises the important point that willingness to donate is not the same as actually donating, and that observed donation rates in European countries tend to be much closer together. Fair point!

However I would add that I'm not sure how helpful I find figure presented at the Crooked Timber link. The data points correspond to organ donation rates by year, but it's not a time series so there's no way to know which points correspond to which year. Furthermore, do all of these points correspond to only being on one side or the other of a change in informed consent law? Or did some of these countries change their informed consent policies during the 1990-2002 time frame? This would be important information to know, particularly if we're interested in whether these laws have any effect on actual organ donation. On my first glance at the paper provided I see that the same data are indeed put in a time series, but again I don't see any indication of when each country's policy was enacted and whether there were any shifts in policy during the study time frame. So, based on that it's hard to really make any kind of inference either way about whether the policies had no effect on actual donation rates.

For another take on this issue, here's a paper by IQSS member Alberto Abadie, which does find an effect of presumed consent laws. I'd be interested to hear Healy's take on this paper!


Posted by John Graves at April 9, 2008 6:20 PM