1. Alice Moseley, Graham Smith & Gerry Stoker Department of Politics & International Relations University of Southampton, Rediscovering the Civic Project, Universities of Manchester & Southampton

2.  UK Surveys report 65%-90% in favour of donating their organs (New et al 2004)  Yet only 26% on ODR (NHSBT, 2009)  8000 people waiting for a transplant  1000 people died waiting in 07/08  50% more organs are needed  Gradual increase in donors but gap between supply and demand growing faster (8% per year) (DH, 2008)

3.  Repertoire of policy tools based around behavioural economics principles (Thaler & Sunstein, 2008)  Heuristics: Cognitive limitations so shortcuts, rules of thumb, eg following the herd or status quo  Loss aversion: We care more about losses than potential gains  Hyperbolic discounting: Calculations that are in our short term but not our long terms interests – ‘Buy now, pay later!’  Yet preferences are constructed not fixed so amenable to govt influence

4.  Govts use nudges to encourage behavioural change (by taking on role of ‘choice architect’)  Eg Changing defaults: recognises status quo bias within decision-making  Eg Information provision: Enabling people to make more informed choices  Organ Donation…. From informed consent to presumed consent? Or mandated choice? Changing defaults  Information nudges

5.  Rather than nudging citizens, government merely provides opportunities for them to think  Deliberation, dialogue, debate, peer education  Deliberative turn in democratic theory & practice  Focus on collective rather than individual behaviour Organ Donation…. Educative effect of discussing and debating.. Lack of awareness one of biggest obstacles…

6. Research Qs  How effective is information provision alone compared to information & deliberation for increasing ODR?  How does information and deliberation affect attitudes towards ODR? Methodology  Post-test only RCT amongst HE students  Data collection via survey administered in lecture theatres

7. Control group:Questionnaire only Treatment Group A:Information + (NUDGE)Questionnaire Treatment Group B: Information + Dialogue (NUDGE & THINK)+ Questionnaire

8. Control GroupTreatment ATreatment B Step 1 IntroductionIntroductionIntroduction 5 min Step 2 QuestionnaireRead info pack Read info pack 15min Step 3 Leave hallWatch videoWatch video 10min Step 4Questionnaire Group discussions 15min Step 5Leave hallQuestionnaire 15min Step 6Leave hall Tot:60min

9.  Dependent on gatekeepers  Permission to link study to actual registration  Non-attendance  Student sample: external validity  Fresher’s Fair contamination

10. Research Qs  How do informed consent (opt in), presumed consent (opt out) and mandated choice questions impact on ODR?  How acceptable do participants find these alternative systems? Methodology  Post test only RCT amongst HE students  Data collected via online survey

11. Group 1: INFORMED CONSENT/ OPT IN (Status quo) Group 2: PRESUMED CONSENT/ (NUDGE 1)OPT OUT (Alternative A) Group 3: FORCED CHOICE (NUDGE 2)(Alternative B)

12. Group 1: Please register my name on the National Organ Donor Register  Group 2: Please register my name on the National Organ Donor Register  (uncheck the box if you DO NOT want to register your name) Group 3: Please register my name on the National Organ Donor Register Yes  No 

13.  Permission to link study to actual registration: will provide opp. to retrospectively re-register  Student sample: external validity  Dealing with non-response/ self-selection bias  May not be possible to include all students: again dependent on gatekeepers