Nudging the dead: How behavioural psychology inspired Nova Scotia’s organ donation scheme


Joseph Brean at National Post: “Nova Scotia’s decision to presume people’s consent to donating their organs after death is not just a North American first. It is also the latest example of how deeply behavioural psychology has changed policy debates.

That is a rare achievement for science. Governments used to appeal to people’s sense of reason, religion, civic duty, or fear of consequences. Today, when they want to change how their citizens behave, they use psychological tricks to hack their minds.

Nudge politics, as it came to be known, has been an intellectual hit among wonks and technocrats ever since Daniel Kahneman won the Nobel Prize in 2002 for destroying the belief people make decisions based on good information and reasonable expectations. Not so, he showed. Not even close. Human decision-making is an organic process, all but immune to reason, but strangely susceptible to simple environmental cues, just waiting to be exploited by a clever policymaker….

Organ donation is a natural fit. Nova Scotia’s experiment aims to solve a policy problem by getting people to do what they always tend to do about government requests — nothing.

The cleverness is evident in the N.S. government’s own words, which play on the meaning of “opportunity”: “Every Nova Scotian will have the opportunity to be an organ and tissue donor unless they opt out.” The policy applies to kidneys, pancreas, heart, liver, lungs, small bowel, cornea, sclera, skin, bones, tendons and heart valves.

It is so clever it aims to make progress as people ignore it. The default position is a positive for the policy. It assumes poor pickup. You can opt out of organ donation if you want. Nova Scotia is simply taking the informed gamble that you probably won’t. That is the goal, and it will make for a revealing case study.

Organ donation is an important question, and chronically low donation rates can reasonably be called a crisis. But most people make their personal choice “thoughtlessly,” as Kahneman wrote in the 2011 book Thinking, Fast and Slow.

He referred to European statistics which showed vast differences in organ donation rights between neighbouring and culturally similar countries, such as Sweden and Denmark, or Germany and Austria. The key difference, he noted, was what he called “framing effects,” or how the question was asked….(More)”.