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Pay to Play: Should Registered Organ Donors Get Priority as Recipients?

(Polka Dot)


The organ donor waiting list in America is a long one. There’s far too much demand for a very limited supply. In 2010, 89,316 people were on the kidney transplant waiting list, while the number of living donors was only 6,282, and the number of deceased donor transplants was 10,622. Freakonomics is no stranger to the repugnant discussion of the organ market. America’s particular organ donation policies, however, aren’t practiced everywhere. Singapore and Israel give priority to potential recipients who were already registered donors. A new working paper written by Judd B. Kessler of Wharton, and Alvin E. Roth from Harvard further tests this idea of priority-to-participants in an incentivized game. Here’s the abstract:

Organ donations from deceased donors provide the majority of transplanted organs in the United States, and one deceased donor can save numerous lives by providing multiple organs. Nevertheless, most Americans are not registered organ donors despite the relative ease of becoming one. We study in the laboratory an experimental game modeled on the decision to register as an organ donor, and investigate how changes in the management of organ waiting lists might impact donations. We find that an organ allocation policy giving priority on waiting lists to those who previously registered as donors has a significant positive impact on registration.

Could this be it? A not-so-repugnant solution to all our organ donation woes? A way to increase the number of registered donors above the current 40% of the adult population in the U.S.? Maybe. The authors explain a little more about the nature of their thought experiment:

It may be that the donor-priority organ allocation policy increases registration rates in part because the allocation rules allow for non-donors to be excluded (or to have a smaller probability of receiving an organ), effectively turning the registry into a club good and generating an incentive to become a donor.


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