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Alice Moseley, Graham Smith & Gerry Stoker Department of Politics & International Relations University of Southampton, Rediscovering the Civic Project, Universities of Manchester & Southampton
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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)
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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
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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
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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…
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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
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Control group:Questionnaire only Treatment Group A:Information + (NUDGE)Questionnaire Treatment Group B: Information + Dialogue (NUDGE & THINK)+ Questionnaire
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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
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Dependent on gatekeepers Permission to link study to actual registration Non-attendance Student sample: external validity Fresher’s Fair contamination
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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
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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)
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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
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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
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