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

It turns out that giving people a chance to say “no” might be detrimental to organ donation efforts. How can we apply the lessons of organ donation to our everyday lives?

Aug 31, 2014 at 12:29PM

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.

How to get even more income during retirement
Social Security plays a key role in your financial security, but it’s not the only way to boost your retirement income. In our brand-new free report, our retirement experts give their insight on a simple strategy to take advantage of a little-known IRS rule that can help ensure a more comfortable retirement for you and your family. Click here to get your copy today.

Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

1 Key Step to Get Rich

Our mission at The Motley Fool is to help the world invest better. Whether that’s helping people overcome their fear of stocks all the way to offering clear and successful guidance on complicated-sounding options trades, we can help.

Feb 1, 2016 at 4:54PM

To be perfectly clear, this is not a get-rich action that my Foolish colleagues and I came up with. But we wouldn't argue with the approach.

A 2015 Business Insider article titled, "11 websites to bookmark if you want to get rich" rated The Motley Fool as the #1 place online to get smarter about investing.

"The Motley Fool aims to build a strong investment community, which it does by providing a variety of resources: the website, books, a newspaper column, a radio [show], and [newsletters]," wrote (the clearly insightful and talented) money reporter Kathleen Elkins. "This site has something for every type of investor, from basic lessons for beginners to investing commentary on mutual funds, stock sectors, and value for the more advanced."

Our mission at The Motley Fool is to help the world invest better, so it's nice to receive that kind of recognition. It lets us know we're doing our job.

Whether that's helping the entirely uninitiated overcome their fear of stocks all the way to offering clear and successful guidance on complicated-sounding options trades, we want to provide our readers with a boost to the next step on their journey to financial independence.

Articles and beyond

As Business Insider wrote, there are a number of resources available from the Fool for investors of all levels and styles.

In addition to the dozens of free articles we publish every day on our website, I want to highlight two must-see spots in your tour of

For the beginning investor

Investing can seem like a Big Deal to those who have yet to buy their first stock. Many investment professionals try to infuse the conversation with jargon in order to deter individual investors from tackling it on their own (and to justify their often sky-high fees).

But the individual investor can beat the market. The real secret to investing is that it doesn't take tons of money, endless hours, or super-secret formulas that only experts possess.

That's why we created a best-selling guide that walks investors-to-be through everything they need to know to get started. And because we're so dedicated to our mission, we've made that available for free.

If you're just starting out (or want to help out someone who is), go to, drop in your email address, and you'll be able to instantly access the quick-read guide ... for free.

For the listener

Whether it's on the stationary exercise bike or during my daily commute, I spend a lot of time going nowhere. But I've found a way to make that time benefit me.

The Motley Fool offers five podcasts that I refer to as "binge-worthy financial information."

Motley Fool Money features a team of our analysts discussing the week's top business and investing stories, interviews, and an inside look at the stocks on our radar. It's also featured on several dozen radio stations across the country.

The hosts of Motley Fool Answers challenge the conventional wisdom on life's biggest financial issues to reveal what you really need to know to make smart money moves.

David Gardner, co-founder of The Motley Fool, is among the most respected and trusted sources on investing. And he's the host of Rule Breaker Investing, in which he shares his insights into today's most innovative and disruptive companies ... and how to profit from them.

Market Foolery is our daily look at stocks in the news, as well as the top business and investing stories.

And Industry Focus offers a deeper dive into a specific industry and the stories making headlines. Healthcare, technology, energy, consumer goods, and other industries take turns in the spotlight.

They're all informative, entertaining, and eminently listenable ... and I don't say that simply because the hosts all sit within a Nerf-gun shot of my desk. Rule Breaker Investing and Answers contain timeless advice, so you might want to go back to the beginning with those. The other three take their cues from the market, so you'll want to listen to the most recent first. All are available at

But wait, there's more

The book and the podcasts – both free ... both awesome – also come with an ongoing benefit. If you download the book, or if you enter your email address in the magical box at the podcasts page, you'll get ongoing market coverage sent straight to your inbox.

Investor Insights is valuable and enjoyable coverage of everything from macroeconomic events to investing strategies to our analyst's travels around the world to find the next big thing. Also free.

Get the book. Listen to a podcast. Sign up for Investor Insights. I'm not saying that any of those things will make you rich ... but Business Insider seems to think so.

Compare Brokers