Don’t Take No For an Answer: Lessons From Organ Donation

Over 10,000 people die every year waiting for an organ donation. It's an abysmal state of affairs, and a major part of the problem is that only 48% of people are registered organ donors.

How do we solve the problem? 

One prominent behavioral theory suggested that letting people make an "active" decision -- that is, a yes or no choice -- rather than checking an opt-in box could help. In a recent paper, researchers Judd Kessler and Alvin Roth tested the theory to find out if it actually works.

As it happens, active choices might actually make things worse. But you (and DMVs across the country) can use this information to learn how to get people to say that magic word: yes.

No means no
Before 2011, California used a simple opt-in format for organ donation, where you could check the box that said "yes" or skip the question altogether.

Flickr / 3n.

In 2011, the state switched to an active option that required a yes or no answer.  The researchers found that donation rates didn't increase, and might have even gone down. They found similar results when testing donation decisions in a lab setting.

When testing how others perceived active choices in a "next of kin" experiment, in which a subject had to make a donation decision on behalf of a deceased loved one, the researchers discovered that people were much less likely to donate if the loved one had said "no" rather than simply not opting-in.

What does it all mean? The researchers conclude that allowing people to actively say no might actually harm donation rates over time. 

The consistency of no
The lesson is it might not be a good idea to let someone articulate the word "no" if what you really want to hear is "yes." 

Even if someone likes the idea of being an organ donor, he or she might stick with "no" simply to be consistent (we like to feel as though we're operating in line with previous choices), or it might just be hard to change one's mind in the face of doubts. Maybe the subject is just too unpleasant to think about, forcing people's hands toward "no" when they might have skipped the question before.

There are a million reasons why someone might say no, but in the case of organ donation it might be better to let them skip the question instead. 

So how can we apply this to other areas of life? 

Getting them to say yes
For successful persuasion, the Godfather suggested making an offer the person couldn't refuse, but perhaps that's a bit extreme.

Instead, the researchers offer a few ideas for getting an organ donor to say yes -- and they are surprisingly useful tips for anyone who makes sales, owns a business, or deals with young children.  

First: Just keep repeating the question.

The study found that simply asking people if they'd like to change their status was surprisingly effective. People were "22 times more likely to add themselves to the registry than remove themselves from the registry, even though all subjects had been asked previously about organ donor registration."

Second: Give more information.

Sometimes people say no only because they're unsure, so remove the barrier of ignorance to help them get to yes. Anticipate questions before they arise, and bring peace of mind with more information. 

After all, if more information can be effective for a subject as potentially unpleasant as donating one's organs, imagine how useful it could be for your widget business!

Finally: Make it personal.

The authors cite previous research which shows that people are more likely to sign up as organ donors if they know they'll get priority status should they happen to need an organ in the future. In other words, giving people something in exchange for their generosity makes them more likely to be generous.

The idea of reciprocity is well-known in persuasion literature, but this is a nice example of how it can work. Make sure that the party you're trying to persuade feels like they have skin in the game, and suddenly they might be much more willing to say yes. 

These tips might not seem new, but viewed from the angle of organs they suddenly feel a bit more salient, at least to your humble author.

Try them out -- and while you're at it, maybe think about becoming an organ donor yourself. Here's some more information from the DMV.

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Anna Wroblewska

Anna began her career in finance as a college intern at a hedge fund, and she hasn’t been able to escape its siren song ever since. She’s done academic research at Harvard Business School and UCLA, was the COO of a wealth management firm, and now writes about finance, economics, behavior, and business.

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