iPhone Altruism for Potential Organ Donors

Organ donation is one of the most altruistic things a person can do. And yet, as Chapter 3 of SuperFreakonomics spells out, relying on altruism for organ donations has proved to be largely unsuccessful. There are a lot of reasons people give for not signing up as organ donors. Often, they just fail to opt in because of laziness or forgetfulness. So Richard Thaler had an idea. Why not build an iPhone app to help people enlist as organ donors? That app, developed gratis, is available now. As to the question of our inherent level of altruism, which app do you predict will get more downloads over all: the one that helps people make a life-saving donation — or the one that helps them pick the right urinal? [%comments]


Ooooorrrrr you could just take the more practical solution and make everyone a donor by default with the ability to opt out, thus making "laziness or forgetfulness" work for the greater good.

Jason S

One problem with that William...it would be illegal to do so. Granted the idea sounds good but that pesky Constitution gets in the way. :)
We could always make organ donation tax deductible...sign up for organ donation and you get a tax credit. If nothing else the healthy rich would have more of a reason to give their organs while the poor and based off most studies less healthy would still donate based off altruism.


People have to address the superstition of organ donation. If I make myself 'available' maybe I'm asking for trouble. A latent Christian 'careful what you wish for' type idea. Until this idea is rejected, people will continue to be superstitious and not sign up.


I wonder how much of this stems from the seemingly routine potrayal of surgeons as organ-hungry vultures, ready and eager to pounce on newly- or not-quite-dead folks and divvy up their precious organs. Thanks to pop culture (I've no idea of the veracity of such ideas), I think a lot of people are more than a little worried that being an organ donor can make you more valuable to a doctor if you're dead than if you're barely alive.

Jonathon K.

I would hope the app that helps with organ donation would get the most downloads.... every man should instinctively know how to chose the right urinal.


Given that I am far more likely to need to find a urinal than find or be an organ donor, I think the answer is clear.

Also, I've just finished reading the SuperFreak chapter on altruism. Here's an anecdotal data point. My wife and I have no children, are over 60 and have been very financially successful. We've made a local college the residual beneficiary of our estate. The only "strings" attached to it is that it be anonymous and that it be used to pay tuition rather than infrastructure. Certain people in the school's administration know who we are and who our attorney is, and they also clearly know our wishes. Nevertheless, we get one or two calls every year asking "Are you SURE you don't want something named after you?" or "Wouldn't you like to come to a dinner honoring donors?" I told them last year (in writing) that if I get one more call like that, we'll pick a different school.

In case you're wondering about our motivations, both my wife and I come from humble backgrounds and were able to go to college and graduate school based on full academic scholarships. This is "pay it forward".



Based on the idea mentioned by Jake (#4 above), I revoked my organ donor status a few years ago. I don't want to end up in a situation where a surgeon is looking at me thinking "my Mercedes S600 is already 7 months old, time for a new one, and I can bill the insurance company $300,000 if I can transplant this guy's kidney to some other guy somewhere, so I think I he's about to stop breathing; I'll be able to cover my tracks easily." I assume that's how someone thinks who makes as much money as a successful surgeon, because the more money someone has, the greedier they get.


Again, this is a problem that has already been solved elsewhere.

European solution:
Make being an organ donor "opt out" instead of "opt in".

Works pretty well. You can opt out easily, without needing to give a reason. And there is no need to pressure anybody, giving the abundance of donors.


Overall organ donors have many excuses not to donate organs and are the majority of us. This new approach to change the perception of organ donation can be efficient. First of all the app must target an audience and must be sure not to give negative incentives to the society out there. Such negative incentives could be not to trust this way of organ donation due to the fact that you are giving out personal information. Also, as far as I know, it is illegal to carry such delicate process that is not under government control.

My parents were never donors for the fact that if someone who requires of an organ becomes greedy due to scarcity power of the donor, violent measures such as killing someone that is a donor may be done in order to obtain the organ.

However, on another perspective, this can provoke incentives to actually make people donate organs and think of the people out there instead of just themselves. However it is a double sided sword. In the end its to each ones ethics over efficiency/personal gain.



The answer to the question is quite evident. People need to use a urinal with more consistency than they donate organs. That is what it is. The donation of organs though, might save someone's life, while the immediate location of a urinal just might not. Because of this reality, it is pleasing to see that the 'Thaler approach' is in effect. This is the line where technology meets morality. The iPhone application might lead to the addition of one, a hundred, or thousands of organ donors to the, well, organ donor list; potentially saving one, a hundred, or thousands of lives. The truth is that some people just don't have the time, forget, or don't care enough to place their name in a pool of people that one day might save one life. Some of these people inevitably have iPhones in today's world of iPhonism and globalization. If one of these people notices the simplicity of registering themselves in the organ donor list, they just might do it, and with it, they just might save one life one day. As easy as that. There is actually very little to lose if someone places a couple of minutes of their lives into adding their information into an organ donor list. In fact, that could be the topic used as an ice-breaker when trying to get a girl. I mean come on, who could resist to a, "Hey, I'm Jean... an organ donor." ;)

Oh...kay... aside from a pathetic excuse for an ice-breaker, being an organ donor can really benefit the world and those around you. It is saving a life for goodness' sake. In economics, if a rational thinker has nothing -- or little -- to lose, that person will take any offer. If you have little to lose, and might actually gain some morality or true altruism, you might want to take a second to become an organ donor (if you could restrain your bladder for that second, that is).


Jason S

Ok so I come into work today and now it makes alot more sense to me why organ donation is difficult...people are apparently crazy. First off the arguement that the reason people don't donate because of some latent Christian I'm asking for it is past crazy and just dumb. Christian organizations not only incourage it but have, for many years, stated that it was a Christian duty to donate.
As far as organ hungry doctors stealing your organs instead of saving you....are you serious? I can only assume you don't know how the medical field works, which granted puts you in with most people, but this statement is also just crazy. Doctors are in no way rewarded for harvesting organs. During an organ harvest the organs are removed and taken all over the country to the person on top of the organ list, rarely is any surgery done from harvest done by the doctor.
As well the idea that if there are to few organs people will just kill eachother to get the organs for themselves is also just crazy. First, there is an organ shortage, there always has been and we don't see an epidemic of murders for transplants. Second, if you needed the organ that badly I doubt you would be in the physical condition to murder a perfectly healthy person, at that point more than likely your lying in a hospital bed dying.
And finally I noted in my first post but I saw it brought up again, under our Constitution you could not have an opt out program, because of the laws protecting privacy and a person's body the government is not allowed to make you donate unless you opt out.



One kidney or partial liver or partial pancreas: these can be donated by a living donor. Here's an idea: why can't the donor of one of these significant organs get a gift in-kind in the form of lifetime insurance coverage from the insurance company of the recipient?

If the recipient is a Medicare patient, let the donor choose to participate in either Medicare or VA (giving up a body part to help another American live: why not let them choose VA?)

Why has no insurance company ever proposed this? Is the cost of dialysis, etc. less than the marginal cost of a new client?


Nik, Do you seriously think that surgeons get a finder's fee for organs? Or that they can in any way determine who will do the transplant procedure or who will receive the organ so that they can receive repayment as quid pro quo? It can't happen--they have no way of knowing these things, so they have no financial or other incentive to let you die for your organs.


Dan, if the finder's fee is not paid in a visible fashion, it can still be paid under the table.


To be honest, the app that would indicate where bathrooms with working urinals are, would be a much better download since it is efficient (cuts transactions costs such as asking people where the bathroom is, running around public areas forever, and suffering unimaginable embarrassments ) The app made as a registration tool to obtain more healthy people on the donor list is with all honesty, a mockery to doctors, those who are donors, and everyday marketeers.

First, even though the iphone has become a phenomenon worldwide the app for organ donor application is not the best way to obtain more people to donate their organs. If health institutions and governments were concerned about the lack of organs available compared to the people who need them, a massive campaign would be launched by the government and health institutions in order to attract people, which with good marketing strategies could work with an astonishing rate.

Second, there are over 500 apps today, when people look at app number 501, there is no buzz or astonishment to this app since people already have from 2 to 30 pages worth of apps on their iphones.

Third, society in many countries is suffering from a decline in morality and ethical boundaries. Why would people care if someone in the other end of the world is dying and need an organ which they could donate without affecting their health when people in Africa dye everyday from simple starvation and it's not even published on newspapers.

Fourth, an app that would be created to serve such a purpose would bring about hundreds of different institutions and individuals attacking its creation.
Religious institutions would contradict the creation of such "vile advancements." Other institutions or individuals might just sign up and claim that the app somehow forced them to sign up by creating social pressures and sue Apple and Health institutions for millions of dollars with the help of good willing lawyers.

In the end, the creation of this app would bring nothing but problems in so many different ways that it's not worth it. Leaving the donor list in the hands of altruism is not the best method to obtain people to enlist however leaving it in the hands of profit seeking institutions is in all ways unethical.



I wouldn't use either one, as I am a bit of a reactionary in that I feel that there are some things which are a waste of technology. Urinal location is one of them.

I would donate an organ to a loved one while alive, but will not donate my organs after death for eugenic reasons.

Yes, I used the "e" word.

I do not want my organs used to the detriment of humanity by extending the life of someone who was selected for death by Nature or their own decisions. If I could control how they were used, I would consider it. Examples:

1) Healthy teenage honor student accidentally overdosed with acetaminophen by medical personnel needs new liver? Check, he can have mine if I'm done using it.

2) Elderly rich actor who spent his life drinking and carousing needs new liver? Suck it up, Buttercup, you ain't getting cell one from me.

I happen to feel that the moral hazard of Type 2 transplants exceeds the moral benefit of Type 1 transplants. Therefore I will not donate my organs since I cannot forbid their use for Type 2 transplants. If you do not agree with my evaluation, you will reach a different decision.



What Keith #12 said, also opt out over opt in.