EXAMINING INFLUENCES OF COLLECTIVISM ON ORGAN DONATION DECISIONS AS DEFAULTS IN OPT-OUT POLICY

Abstract

In organ donation, opt-out policies – whereby individuals are presumed as consenting organ donors by default unless they explicitly decide against donation – have improved organ donation rates worldwide, but with varying degrees of adoption and effectiveness across cultures. Yet, existing literature investigating individualism-collectivism differences in organ donation decisions fail to explain donation decisions contextualized as presumed-consent defaults. Drawing on existing literature, we hypothesize that collectivistic cultural orientations inhibit default organ donation decisions under an opt-out policy due to social influences and collective considerations in decision-making. In Study 1, participants primed to be either more collectivistic or individualistic do not differ in their donation decisions when responding to an opt-out policy. By examining participants’ innate cultural orientations in Study 2, individualism-collectivism orientations neither influenced participants’ donation decisions regardless of whether they are by default or actively made, nor differentially influenced organ donation decisions across decision types. Despite non-significant findings, both studies provided evidence for robust effects of defaults in opt-out policy. Together, these findings point to a need for greater caution in using general individualism-collectivism orientations to explain cross-cultural differences in donation decisions under opt-out policy. Implications of these findings on policy development and broader cross-cultural organ donation research are discussed.