Nudging on organ donation

The British Government has decided to introduce a system of "prompted choice" on organ donor registration when people apply online for driving licenses from July 2011. Under this, applicants will be prompted to say "yes", "no", or "I do not want to answer this now" to a question about whether they want to donate their organs. It is believed that by prompting people into making a choice, more people can be made to register for organ donations.

In contrast to "prompted choice", under the "presumed consent" policy, all people are assumed to be willing to donate their organs unless they specifically choose to opt out. Experience from many countries and some US states shows that either types of policies have significantly increased the number of organ donors. Prompted choice schemes in US states like Illinois, for example, have increased donor registrations from 38% to 60% of the population. Spain, Austria, and Belgium have presumed consent organ donation legislations, which have yielded higher donor rates.

Organ donation policies in India revolve around awareness creation and piecemeal campaigns to enrol signatures from potential donors. For example, the National Blindness Control Program has a campaign to get people to donate their eyes. These programs are marked by meaningless campaigns (because these consents have no legal standing) to enlist signatures of potential donors. Celebrities are enlisted and substantial amounts spent, without any tangible results.

It is time that the Government of India embrace either prompted or presumed consent policies, with specific variations to suit our requirements. This would be an example of moving beyond conventional regulations, incentives and awareness-based policy-making to one that applies insights from behavioural psychology.