Susan has the difficult task of negotiating honestly while convincing Treadstone
that her performance is acceptable. Nobody said that ethical conduct is always
easy. True, if it is simply impossible for Susan to stay on as negotiator if she
plays it clean, then the utilitarian argument evaporates. Someone else will step in
12. Opt in or opt out. Countries typically use an opt-in or opt-out approach to
organ donation. Opt-in countries give people an opportunity to sign a donor card
to grant permission to us their organs. Opt-out countries assume that people give
permission unless they fill out a form or make a phone call to revoke consent.
Johnson and Goldstein report that organ donor consent is much higher in opt-out
countries. If permission to donate is the default, people tend to let it stand. They
are much more reluctant to give permission by overriding a default. Table 6.3
shows the rates for European countries. (The Netherlands’ relatively high opt-in
rate is due to an aggressive public campaign.) In the United States, an opt-in
country, 85% of people “approve” of organ donation but only 28% grant
permission. The article states that more than 45,000 people in the United States
died in 1995 while awaiting a donor organ. It suggests that many lives could be
saved by switching to an opt-out policy.
Because opting out requires some effort in Europe, one may ask whether the
inconvenience of opting out explains the low rates. Johnson and Goldstein
conducted an online survey of 161 U.S. respondents, who were asked to assume
that they had just moved to a new state. Question 1 asked them if they would opt
in to organ donation if given the opportunity. Question 2 asked if they would opt
out. Question 3 asked how they would respond if required to choose whether to
donate (with no default). The results (Table 6.4) show that only half as many
people donate when required to opt in. Defaults therefore remain a key factor
even when no effort is involved.
Is it ethical to use an opt-out system to save lives? Or is it dishonest? A rational
agent would presumably make the same choice regardless of the default. The low
opt-out rate suggests that an opt-out system plays on psychological factors that
distort the agent’s true intent. There are substantial opt-in/opt-out differences for
online privacy, selection of insurance coverage, and the level of pension savings.
Hints. There are several possible explanations for why people opt out, such as:
1. It is too much trouble to opt out.