Underlying Wishes and Nudged Choices

• Published in: Journal of experimental psychology. Applied Vol. 24; no. 4; pp. 459 - 475
• Main Authors: Lin, Yiling, Osman, Magda, Harris, Adam J. L., Read, Daniel
• Format: Journal Article
• Language: English
• Published: United States American Psychological Association 01-12-2018
• Subjects: Adolescent; Adult; Charitable Behavior; Choice Behavior; Cross Cultural Differences; Europe; Family; Female; Human; Humans; Inference; Legislative Processes; Male; Middle Aged; Preferences; Test Construction; Tissue and Organ Procurement - legislation & jurisprudence; Tissue Donation; Tissue Donors - psychology; Uncertainty; United States; Young Adult; United States; Europe; nudges; default options; organ donation; underlying preference
• ISSN: 1076-898X; 1939-2192
• DOI: 10.1037/xap0000183

Is the inferred preference of a deceased relative to donate his or her organs stronger when the choice was made under a mandated rather than under an automatic default (i.e., nudged choice) legislative system? The answer to this is particularly important, because families can, and do, veto the choices of their deceased relatives. In three studies, we asked American and European participants from countries that have either a default opt-in or a default opt-out system to take on the role of a third party to judge the likelihood that an individual's "true wish" was to actually donate his or her organs, given that the decedent was registered to donate on the organ donation register. In each study participants were randomly assigned to one of four organ donation legislative systems (default opt-in, default opt-out, mandated choice, mandatory). Overall, regardless of which country participants came from, they perceived the donor's underlying preference to donate as stronger under the default opt-in and mandated choice systems as compared with the default opt-out and mandatory donor systems. We discuss the practical issues that result from using default systems in the domain of organ donation and propose potential ways to ameliorate the uncertainty around inferences of underlying preference from a nudged choice.
Public Significance Statement
This study suggests that signals of an organ donor's underlying preference are stronger when the choice (from which his or her preference is inferred) was made under a mandated or default opt-in system rather than under a default opt-out system. We found that ambiguous signals of underlying preference that are attached to default opt-out systems contribute to families' veto decisions as compared with active choice systems (opt-in, mandated-choice), which are substantially better at signaling intent than are passive ones. We proposed potential solutions to ameliorate uncertainty around inferences of underlying preference from a nudged choice.