Nudge, Nudge or Shove, Shove—The Right Way for Nudges to Increase the Supply of Donated Cadaver Organs

Abstract

Richard Thaler and Cass Sunstein (2008) contend that mandated choice is the most practical nudge for increasing organ donation. We argue that they are wrong, and their mistake results from failing to appreciate how perceptions of meaning can influence people's responses to nudges. We favor a policy of default to donation that is subject to immediate family veto power, includes options for people to opt out (and be educated on how to do so), and emphasizes the role of organ procurement organizations and in-house transplant donation coordinators creating better environments for increasing the supply of organs and tissues obtained from cadavers. This policy will provide better opportunities for offering nudges in contexts where in-house coordinators work with families. We conclude by arguing that nudges can be introduced ethically and effectively into these contexts only if nudge designers collaborate with in-house coordinators and stakeholders.

Using a verbal prompt to increase protein consumption in a hospital setting: a field study

“…Verbal prompts are sometimes perceived to be obtrusive or pushy [ 36 ] and may cause resistance or even counterproductive effects (e.g. increasing unhealthy food consumption) [ 37 , 38 ]. However, when care is taken, perceived obtrusiveness can be avoided [ 25 ].…”

Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12–25 Years of Age)

“…Some commentators have suggested that to discourage people from opting out, the process can be made more difficult by including requirements for the parent or guardian to sign a declination of testing in person at the testing site, or in front of a notary public, after receiving and understanding valid information about the risk of sudden cardiac death in young people from an appropriate healthcare provider. 274 Children themselves have the right to assent to or decline testing if they are mature enough to understand the nature of the testing and the risks involved to their privacy and ability to play sports. Many states recognize that as children mature, they should become the guardians of their own personal health information and partners in medical decision-making, supplementing the responsibility ordinarily held by their parents.…”

A döntési helyzetek tudatos tervezésének háttere. A nudge fogalma, módszerei és kritikái

“…Ha például egy nudge segítségével elérjük, hogy az emberek kevesebb egészségtelen fánkot fogyasszanak, lehet, hogy csak az aprósütemények utáni keresletet növeljük így meg (Huang -Baum, 2012). A már említett szervadományozási kérdésnél többen úgy érvelnek, hogy a feltételezett beleegyezés (presumed consent) az egyéni szabadságjogokat sérti meg, hiszen veszélyezteti az egyéni döntéshozó autonómiáját, és ilyen esetekben legalább a családtagok számára biztosítani kellene a vétó lehetőségét (Whyte et al, 2012). Amerikai felmérések szerint egyesek attól félnek, hogy ha potenciális szervdonorokká válnak, nem kapnak olyan intenzív ellá-tást, mint azok, akik nem ajánlották fel szerveiket haláluk után.…”