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A similar idea is that of "nudges" as developed by Richard Thaler and Cass Sunstein. Nudges are ways to create a framework of choice that is structured in a way to encourage people to make the "optimal" choice anyway. It requires a bit of psychology in understanding the flaws in people's decision-making and perception.

Some countries have high organ donor participation merely because they structure it as opting out rather than opting in. Instead of signing up as a donor, people have to sign a form to opt out. Is it better than rewarding people who do opt in, as in the incentivized altruistic plan?

At least in terms of a retirement savings plans doing the same thing, I think the automatic opt-in mechanism is better, but organ donations are trickier because they usually involve some emotional or religious conundrum over organ donation.



religious conundrum

I'm kind of torn on this, because often the religious conundrum is a result of poor understanding of one's own religion. For example, I know a Catholic or two who thinks that the Church prohibits organ donation on the theory "Well, cutting edge medicine is probably forbidden, and I'm a good Catholic, so..." which is not an accurate gloss of what the Church actually says about medicine (+). Now if you structured it as an opt-out, you might be able to have a "teachable moment" there with a little application packet that said blah blah blah "And by the way, most religious leaders are broadly supportive of organ donation."

My reason for the wariness is that many religions (and I suppose Catholicism as practiced by many Catholics) do not have a convenient option to look up an authoritative answer on the subject, and that means the slightly confuddled determination of a believer in ignorance of their own religious tradition might actually count as authoritative for them.

+ Catholics think organ donation is a virtuous act, subject to a few restrictions which are not applicable to the mainstream of organ donation policies.




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