Organ donation policies are reducing organ donors

Opt-out organ donation system discourages living organ donations, finds new research from Vienna University of Economics and Business (WU).

Analysing epidemiological data from countries that adopted opt-out defaults between 2000 and 2023, Pascal Güntürkün, Associate Professor at the Department of Marketing at WU, found that while the shift produced only a modest and statistically insignificant rise in deceased donors, it coincided with a significant 29% decline in living donors.

People in opt-out countries are more likely to believe that organ supply needs are already met—dampening their willingness to make altruistic, living donations to strangers or friends.

Across four additional pre-registered studies, this perception bias consistently reduced willingness to donate while alive, particularly among potential altruistic donors rather than family donors.

The findings challenge a long-held assumption among policymakers that opt-out systems are an unambiguous success. Although the approach has been hailed as a cost-effective way to increase organ supply and save lives, the study suggests that net welfare gains may be smaller, or even neutral, once declines in living donations are accounted for.

“Opt-out defaults have long been viewed as a behavioural policy triumph,” says Professor Güntürkün. “But our data show that their psychological spillover effects can blunt overall social impact. Policymakers need to communicate clearly that deceased donations alone cannot meet demand, and that living donors remain vital.”

The study raises broader questions about behavioural “nudges.” As the authors note, similar complacency effects could undermine pro-environmental or public health efforts that rely on default participation.

The study was published in the journal PNAS Nexus.

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For more information, a copy of the report, or to speak to the researcher, contact Thomas Willis at BlueSky Education on thomas@bluesky-pr.com or call +44 (0)1582 790 706.