Are you an organ donor? Check your license. If the answer is yes, do you remember agreeing to become an organ donor? It might seem too far in the past or you were too excited about passing your driving test, but in the chaos of the DMV, you either checked a box or signed your name opting in to putting the words “Organ Donor” on your license. This opt-in system is the standard in the United States. According to the U.S. Department of Health and Human Services, 95% of American adults support organ donation, but only 54% actually sign up as donors. In another shocking statistic, 18 people die everyday waiting for a transplant (3). So why the discrepancy between opinion and action? Myths surrounding organ donation and even the wording used in donor registration both play a vital role in the United States’ low number of organ donors.

Everyone has heard a friend or family member explain their decision not to be an organ donor with the words, “I’m worried that if I’m really sick, a doctor may purposefully let me die to use my organs.” When medical students become physicians, they take the Hippocratic Oath. In summary, the oath impels the taker to follow an ethical set of values to “do no harm” and prioritize the life of the patient over all else (5). In other words, donation legally cannot cross the physician’s mind until all other lifesaving attempts have occurred. I do not vouch for the moral righteousness of each physician, but a physician who would willingly let a patient die to harvest organs will not be a physician much longer.

Another common misconception about organ donation revolves around religious ethics. Contrary to popular belief, a wide variety of religious groups accept and promote organ donation as a “charitable act that saves or enhances life” (4).  Pope John Paul II encouraged Christians to become organ donors, stating “The Catholic Church would promote the fact that there is a need for organ donors and that Christians should accept this as a ‘challenge to their generosity and fraternal love’ so long as ethical principles are followed” (2).  The Catholic Church is not the only religious affiliation to accept organ donation, with acceptance displayed by the Amish, Sikhs, Buddhists and Mormons among others. With so many different religious groups seemingly  promoting the generosity of organ donation, why do donor numbers still remain so low in the United States?

In countries such as Australia, organ donation is the default option at a person’s death. This does not mean, however, that every Australian is forced to be an organ donor. Australia has an opt-out system, meaning that the wording when asked about organ donation is altered slightly compared to that in the United States (3). In an opt-out system, citizens are asked if they would like to not donate their organs, whereas an opt-in system asks citizens if they would like to be an organ donor. This syntax detail may seem minute, but it makes all the difference. By opting out of organ donation, the human mind views this as a selfish and somewhat cruel action, as if one is deliberately refusing to save lives. On the contrary, in the opt-in system, not agreeing to become an organ donor does not affect your conscience because it never was the default option. While this may seem far-fetched, science has proved the legitimacy of this difference.

Social psychologists Shai Davidai, Thomas Gilovich, and Lee Ross became intrigued by the massive discrepancy between organ donors in opt-in versus opt-out countries. Through various experiments, they came to the conclusion that organ donation is influenced by the social norm of the country as represented by the default option used by that country’s organ donation program (1). In other words, if organ donation is the national default, you are viewed as somewhat of a pariah if you opt out of such a normalized and widely accepted social norm. When you are asked to opt in to organ donation, such a feat is seen as an act of altruism or even heroism, thus reducing the pressure to become an organ donor. The power lies in the phrasing, and the difference affects thousands of lives.

The transplant waiting list grows daily. According to UNOS – the United Network for Organ Sharing – 116,512 people are waiting for a viable organ in the United States as of October 3, 2017, 10:21 PM. One donation can save up to eight lives. You could be the difference for eight other fellow citizens. I do not ask you to opt in to something that is contrary to  your personal beliefs, but I do ask you to consider organ donation next time you renew your license at the DMV. You have the power to save lives; all you have to do is say yes.


REFERENCES

  1. Davidai, Shai, Thomas Gilovich, and Lee D. Ross. “The Meaning of Default Options for Potential Organ Donors.” Proceedings of the National Academy of Sciences of the United States of America 109.38 (2012): 15201–15205. PMC.
  2. Faith.” Center for Organ Recovery & Education, 2017. https://www.core.org/community-outreach/community-education/faith/
  3. Thaler, Richard H. “Opting in vs. Opting Out.” The New York Times, The New York Times, 26 Sept. 2009, www.nytimes.com/2009/09/27/business/economy/27view.html?_r=0.
  4. “Theological Perspective on Organ and Tissue Donation” UNOS, 2017. https://www.unos.org/donation/facts/theological-perspective-on-organ-and-tissue-donation/
  5. Tyson, Peter. “The Hippocratic Oath Today.” PBS, Public Broadcasting Service, 27 Mar. 2001, www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html.

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