Reciprocity and Need in Posthumous Organ Donation

Abstract

The effects of need and reciprocity on prosocial behavior have been primarily studied in separate research domains. A distinction between helping those in need and reciprocity is also made in current discussions on how to motivate posthumous organ donation, contrasting the help of needing patients with an equal contribution to a common pool of organs and effective measures against free riding. The authors examined the interactive effects of need and reciprocity on moral emotions relevant for helping (e.g., sympathy, guilt, moral anger) in an experiment in which participants imagined donating or not donating their organs to patients who were or were not willing to donate themselves and who differed in the need for an organ. They found that lack of reciprocity reduced the intensity of certain moral emotions (e.g., sympathy, guilt) but only under low need. High need appeared to arouse forgiveness for free riding. Implications for attempts to increase the number of registered organ donors are discussed.

Framing Posthumous Organ Donation in Terms of Reciprocity: What Are the Emotional Consequences?

“…The present study confirmed that a reciprocity focus on posthumous organ donation may have important consequences for the arousal of moral emotions (see also Stijnen & Dijker, 2011). In agreement with notions of reciprocity, people who do not contribute to the common pool of cadaver organs (i.e., free riders) tend to arouse anger, whereas failing to donate organs oneself arouses guilt and pity or sympathy, all emotions that are generally seen as functional for maintaining stable patterns of reciprocity and morality (Baumeister et al, 1994;McCullough et al, 2001;Tangney et al, 2007;Trivers, 1971).…”

“…In the present research, we extended the study by Stijnen and Dijker (2011) by including the crucial manipulation of participants' perspective. We hypothesized that adopting a donor perspective on organ donation would accentuate the consequences that donation has for others' well-being, whereas adopting a recipient perspective would make more salient how others' donation or failure to donate affects one's own well-being.…”

“…While Stijnen and Dijker (2011) employed only a donor perspective, there are important theoretical and EMOTIONAL ASPECTS OF ORGAN DONATION 257 practical reasons to also include a condition in which participants are required to adopt a recipient perspective, inviting them to imagine that they themselves would be in need of an organ and that another person, who had just died, could potentially supply one, dependent on his or her registration status. The theoretical contribution of including such a perspective would be that it has the potential to reveal the strength of the altruistic motives for registering as an organ donor.…”

“…We used the same emotion words and answering scale (1 ¼ not at all, 7 ¼ very much) as in Stijnen and Dijker (2011), and constructed the same scales. In particular, the following four scales were constructed: Fear, consisting of the items fear, nervousness, and tension (Cronbach's a ¼ .88); Anger, consisting of the items anger, irritation, and indignation (a ¼ .81); Pity, measured by the items pity and concern for others (a ¼ .61); and Positive Self-Feelings, measured by pride, self-confidence, and happiness (a ¼ .71).…”

“…In particular, as it has been pointed out that the common pool of organs suitable for transplantation can only be large enough to relieve the needs of patients waiting for an organ if most members of society are obliged to register as donors, mutual dependency and reciprocal helping are emphasized, and free riding (i.e., taking but not giving organs) is discouraged (e.g., Nadel & Nadel, 2005;Robertson, 2007;Siegal & Bonnie, 2006). Stijnen and Dijker (2011) were the first to study how people respond emotionally to a reciprocity perspective on organ donation, asking research participants to imagine that, after having been declared dead, they would be able (due to prior registration as donor) or not able (due to a failure to register) to posthumously donate an organ to a patient who also varied in registration status. A limitation of this study, however, was that it did not examine how people respond to reciprocity when adopting the perspective of a potential recipient of organs.…”