Influencing relatives to respect donor autonomy: Should we nudge families to consent to organ donation?

Refusing consent to organ donation remains unacceptably high, and improving consent rates from family or next‐of‐kin is an important step to procuring more organs for solid organ transplantation in countries where this approval is sought. We have thus far failed to translate fully our limited unders...

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Bibliographic Details
Published in:Bioethics 2018-03, Vol.32 (3), p.155-163
Main Authors: Sharif, Adnan, Moorlock, Greg
Format: Article
Language:English
Subjects:
Autonomy
Behavior change
Behavior modification
Bioethics
Biological organs
Blood & organ donations
Cognitive ability
Cognitive bias
Cognitive psychology
Consent
Decision making
Donors
Intervention
nudging
organ donation
Permission
Positive reinforcement
Reinforcement
Relatives
Transplantation
Transplants
Understanding
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Summary:Refusing consent to organ donation remains unacceptably high, and improving consent rates from family or next‐of‐kin is an important step to procuring more organs for solid organ transplantation in countries where this approval is sought. We have thus far failed to translate fully our limited understanding of why families refuse permission into successful strategies targeting consent in the setting of deceased organ donation, primarily because our interventions fail to target underlying cognitive obstacles. Novel interventions to overcome these hurdles, incorporating an understanding of cognitive psychology and behavioral change therapy, may be beneficial. One potential intervention is to use the concept of nudge theory, where decision‐making is influenced by encouraging positive reinforcement and indirect suggestion. Purposefully nudging families to given consent for organ donation by understanding, and then overcoming, their inherent cognitive biases is novel but also controversial. This article explores the roles of relatives in decisions about organ donation, how nudge theory translates to organ donation and discusses the arguments for and against its application.
ISSN:0269-9702
1467-8519
DOI:10.1111/bioe.12420