Defaults and Donation Decisions

Transplantation, Vol. 78, No. 12, pp. 1713-1716

4 Pages Posted: 7 Jan 2009

See all articles by Eric J. Johnson

Eric J. Johnson

Columbia Business School - Marketing

Daniel G. Goldstein

Microsoft Research New York City; London Business School

Date Written: December 2004


The well-documented shortage of donated organs suggests that greater effort should be made to increase the number of individuals who decide to become potential donors. We examine the role of one factor: the no-action default for agreement. We first argue that such decisions are constructed in response to the question, and therefore influenced by the form of the question. We then describe research that shows that presumed consent increases agreement to be a donor, and compare countries with opt-in (explicit consent) and opt-out (presumed consent) defaults. Our analysis shows that opt-in countries have much higher rates of apparent agreement with donation, and a statistically significant higher rate of donations, even with appropriate statistical controls. We close by discussing the costs and benefits associated with both defaults as well as mandated choice.

Keywords: Organ donation, Decision, Defaults, Policy

Suggested Citation

Johnson, Eric J. and Goldstein, Daniel G., Defaults and Donation Decisions (December 2004). Transplantation, Vol. 78, No. 12, pp. 1713-1716. Available at SSRN:

Eric J. Johnson (Contact Author)

Columbia Business School - Marketing ( email )

New York, NY 10027
United States

Daniel G. Goldstein

Microsoft Research New York City ( email )

641 Avenue of Americas
New York, NY 10011
United States

London Business School ( email )

Sussex Place
Regent's Park
London, London NW1 4SA
United Kingdom
+44 0 20 7000 8611 (Phone)
+44 0 20 7000 8601 (Fax)


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