In the week where we celebrate our latest cohort of economics graduates, we are also releasing the results of this years IAESV Economics Blogpost Competition. This year’s runner up is Charlotte Cracknell, a final year undergraduate. Here is her submission:

Not enough people are signed up to the organ donation register in the UK. Today there are 5,176 on the organ transplant waitlist, but due to a lack of people registered, some will not get the chance to receive a donated organ.

Yet I see a simple economic principle which could change this, nudge theory. Currently, the UK operates with an opt in system, meaning you must state that you want to donate your organs, if you do nothing you will not be registered. However, from the 20th May the UK will operate with the opt out system, this means that everyone is automatically on the organ donation register, and individuals must log in and remove themselves from the list. This change in policy is described as a “nudge”. Richard Thaler’s nudge theory is based on behavioural economics and uses small changes to sway individuals choices and decisions, Thaler won the Nobel for his work in 2017.

Organ donation is one area where nudge theory works. Many people simply cannot be bothered to register, did not realise they had to or have not thought about registering. When making decision people use heuristics, these are rules of thumb that makes decision making easier. Classical economics states that individuals should be rational and use all available information when making a decision, however this is not the case. By simply changing the register from opt in to opt out, more people will be on the register. Although the percentage of the population on the register in the UK has risen to 38% in 2018/2019, this is still low compared to other European countries that have opt out registers, who’s donor rates are around and above 90%. This disproves classical economics that would assume that regardless of the type of donation register, the level of donation would be the same.

The simple nudge from having an opt in to having to opt out, can make a big difference in the percentage of the population on the donation list. David Halpern explains how this nudge works in his book, Inside The Nudge Unit. He proposes:

E – Easy

A – Attractive

S – Social

T – Timely

A nudge must follow at least one of the EAST criteria to be successful. In the case of changing the organ donor register from opt in to opt out, the key criteria hit is it being easy. We’ve all been in the situation where we would be willing to do something, but the paperwork is too long and too much hassle so instead we decide that we can’t be bothered. The public no longer has to opt in, it is already done for them, removing the hassle factor and harnesses individual’s inert likelihood to stick to the default.

It is also social, the data for other European countries with opt in schemes is clear, over 90% of people are on the organ donation list. Individuals are highly influenced by what they think others think about them. If they know that most people are willing to be organ donors, they are likely to also be an organ donor, as they do not want to be different. People like to fit the social norm and be the same as their friends.

Therefore, it seems clear, changing from an opt in to an opt out still allows people to have their own opinion on organ donation and choose if they want to take part or not, but plays on individuals heuristics. To some it is a shock that classical economics is out of date, even though it originates in the late 18th century! To many it is obvious that it needs updating and behavioural economics offers this modern twist. Simple rules of thumb that individuals base their decision on mean people are more likely to donate if a register is opt in due to it being both Easy and Social. So, there we have it, how to increase the UK’s level of registered organ donors can be understood by behavioural economics. Not only this, but the UK’s decision to change its policy to opt in could use economics to solve the issue.