Researchers look to optimize donations in the United States

In the United States, one organ donor can save up to eight lives.

Yet many object to becoming a potential donor due to religious reasons, concerns with fairness of the current first-come, first-serve system and a lack of clarity, Director of the Center for Bioethics Art Caplet wrote in an email.

Wharton professor Judd Kessler is currently working with Harvard University professor Alvin Roth to find ways to optimize organ donations, specifically kidney donations.

Both professors set up an experiments at Harvard’s equivalent of the Wharton Behavioral Lab, where they asked participants to play a game.

Participants were given three units, one labeled A and two labeled B. The A unit represented a brain to the researchers, whereas the B units were kidneys.

However, the participants did not know that the units correlated to organs. Instead, they were told they could earn money when their A unit and at least one B unit was functioning, although there was a probability that either unit would fail during the game.

Before learning if their units would fail, the participants had to make the decision to donate.

According to Kessler, this experiment was a “simplified version of the decision that we’re actually interested in.”

Through variations of the game that manipulated incentives, Kessler and Roth were able to model how organ donation could be more appealing to participants.

For example, Kessler and Roth offered donor priority to those who were willing to donate their units. Kessler described this way of creating incentives as a “club system” as opposed to a “public system.”

According to Kessler, the United States organ donor list currently functions as a public system. This method is equivalent to an event with a first-come, first-serve entry policy.

The club system, however, would be comparable to a private club party where members were given priority over ordinary guests.

Some countries such as Singapore and Israel are beginning to use the club model, Kessler said, adding that this system provides higher incentives for individuals to donate their organs.

Yet Caplan is against applying the club model in the United States.

For Caplan, such systems “don’t pan out in the real world due to biological limits and the fact that the larger the pool of donors, the lower the chance you have of getting priority,” he wrote.

Instead, he would suggest a system in which everyone is automatically registered as a donor but is given the option to decline — a type of system is widely used in Europe.

In the future, Kessler and Roth hope to move the project forward and apply the theories they conceived from decision games to actual organ donation scenarios.

For Kessler, the real-life implication of his study makes it unique.

“It is nice to work on a project that has real practice implications for people’s health and their lives,” he added.

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