Health & Human Services

When it Comes to Organ Donation, the Message Matters

Nearly all Americans support organ donation, but only a third are registered donors. A study in the United Kingdom offers insight into what gets people to give up a part of themselves.
by | May 2014
Donated organs are stored in the freezer at a research institute in Arizona.
Donated organs are stored in the freezer at a research institute in Arizona.

This story is part of Governing's annual International issue.

The longstanding problem with organ donation is the divide between people’s overwhelmingly positive attitudes toward it and their actual participation: In the U.S., 95 percent of the population supports organ donation, but only about a third are actually registered donors, according to the Department of Health and Human Services. That gap of more than 60 percent almost exactly mirrors the divide in the United Kingdom, where researchers recently discovered a truth that political pollsters have long held dear -- messaging is everything.

The U.K.’s National Health Service recently conducted a randomized experiment in which it tested seven different prompts and one control message on people completing online vehicle registration or renewals. The psychology behind each message varied. One pressed social norms (“Every day thousands of people who see this page decide to register.”). Another tested the effectiveness of a “loss frame,” which in this case meant reinforcing the ramifications of doing nothing (“Three people die every day because there are not enough organ donors.”). One tried the opposite, or a “gain frame,” that reminded visitors they could “save or transform up to 9 lives as an organ donor.” The researchers also tried to appeal to people’s “inherent desire for fairness.”

That last message, which proved the most effective, went like this: “If you needed an organ transplant, would you have one? If so, please help others.” During the trial, 1,203 more people registered under that message compared to the control prompt, which translates to an additional 96,000 donors a year. Applying that message consistently and on a wider scale across the U.S. donor-network infrastructure, this study in behavioral science could prove useful, says Tom Mone, former president of the Association of Organ Procurement Organizations.

That’s not to say the U.S. system significantly lags behind its peers; its overall donation rate still ranks fourth-highest in the world, and second by some counts. In fact, the U.S., along with Spain, is considered a model.

The key difference between the U.S. and Spanish systems is that the former is voluntary and the latter presumes consent automatically. “There is no doubt that in Spain the strong unified national message that donation is a social norm and is built into the fabric of the system is something we could all learn from,” says Mone, “and I think the British are learning from that as well.”

Source: World Health Organization

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