A little nudge goes a long way in increasing organ donor registrations.

• Author: Robitaille, Nicole
• Position: Feature: Health Law

Each year, hundreds of Canadians die waiting for organ transplants. At the end of 2017, for example, 4,333 people were waiting for transplants; 242 of them died.

Many of these deaths could be prevented if people signed their organ donor registration cards. And even though the vast majority of Canadians support organ donation, less than 23 per cent have made plans to donate.

With one organ donor having the potential to benefit more than 75 people and save up to eight lives, is there a way to encourage more people to sign an organ donor card? Our research reveals there is.

Behavioural science tells us that there are some key psychological barriers that prevent people from becoming organ donors, including what's known as the status quo bias--meaning we tend to stick with the status quo, or current state of affairs, even when making a change would better align with our personal beliefs and goals.

Developing interventions to overcome these barriers has the potential to close the gap between the 81 per cent of Canadians who indicate they're willing to donate their organs after death and the mere 23 per cent who are registered.

In fact, during an eight-week trial conducted with the Ontario government at one Service Ontario centre, such interventions led to a dramatic increase in organ donor registrations.

Nudging people into action

Those who haven't given the idea much thought are sometimes caught off guard by the question of whether they want to donate their organs after death. And when people are asked to make a decision that they don't feel they've put adequate time and effort into considering, they choose not to decide. They put it off.

In many jurisdictions, the decision to donate organs happens most often when people renew their driver's licences or health cards. In Ontario, for example, 85 per cent of organ donor registrations occur at Service Ontario centres via a prompted-consent system. Customer service representatives ask if people are willing to register to be an organ donor.

To improve the process at Service Ontario centres and avoid surprising people with the question, a number of interventions were tested, from simplifying the organ donor registration form to providing the form earlier in the process and giving key information at optimal points in time.

Another change: At the top of each consent form, several statements in bold text were tested: "If you needed a transplant, would you have one?" And: "How would you feel if you or...