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In his book, Thinking, Fast and Slow, Daniel Kahneman highlights the importance of framing in terms of shaping our decisions; the way we are asked can have a very large influence on what we do, and this in turn can be very influential as regards the well being of society1. As regards organ donation, he cites research showing that the rate is very much higher if the citizenry are assumed to have agreed to donate unless they opt out, compared with those jurisdictions where one has to opt in to qualify as a donor. In Austria and Sweden, where you have to opt out, the rate of donation is respectively 100% in Austria and 86% in Sweden. This compares with 12% in Germany and 4% in Denmark, where you have to opt in. In a letter to the Irish Times on July 26th, 2013, UCD economist Kevin Denny provides a more nuanced interrogation of the evidence.
Ireland is an ‘opt in’ country, with predicable shortage of organs – close to 700 people are on a waiting list. Spain is ‘opt out’, and leads the performance in terms of deceased organ donors; in 2011, it was 35.3 per million people compared with 20.7 for Ireland, and 17.0 for the UK2.