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‘Relative Consent’ or ‘Presumed Consent’? Organ donation attitudes and behaviour

Author

Listed:
  • Joan Costa-Font

    (London School of Economics and Political Science (LSE))

  • Caroline Rudisill

    (University of South Carolina)

  • Maximilian Salcher-Konrad

    (London School of Economics and Political Science (LSE))

Abstract

Legislation, in the form of presumed consent, has been argued to boost organ donation but most evidence disregards the practice of seeking relative’s consent, which can either ‘veto’ donation decisions, or ‘legitimize them’, by removing any possible conflict with the donor’s family. We study the effect of presumed consent alongside family consent on individuals’ willingness to donate (WTD) one’s own and relatives’ organs, and on actual organ donation behaviours. Using data from 28 European countries for the period 2002–2010, we found that presumed consent (PC) policies are associated with increased willingness to donate organs, but this effect was attenuated once internal family discussions on organ donation were controlled for. Our findings indicate that relative’s consent acts as a veto of donation intentions and attenuates the effect of regulation on actual donations. More specifically, PC increases WTD one’s own and relatives’ organs in countries where no family consent is required. Consistently, we find that family consent attenuates the influence of regulatory environment on actual donations. The effect is driven by the influence of family discussions which increased WTD, and in combination with presumed consent translated into higher organ donation rates.

Suggested Citation

  • Joan Costa-Font & Caroline Rudisill & Maximilian Salcher-Konrad, 2021. "‘Relative Consent’ or ‘Presumed Consent’? Organ donation attitudes and behaviour," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 5-16, February.
  • Handle: RePEc:spr:eujhec:v:22:y:2021:i:1:d:10.1007_s10198-020-01214-8
    DOI: 10.1007/s10198-020-01214-8
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    1. Abadie, Alberto & Gay, Sebastien, 2006. "The impact of presumed consent legislation on cadaveric organ donation: A cross-country study," Journal of Health Economics, Elsevier, vol. 25(4), pages 599-620, July.
    2. Joan Costa-Font & Mireia Jofre-Bonet & Steven T. Yen, 2013. "Not All Incentives Wash Out the Warm Glow: The Case of Blood Donation Revisited," Kyklos, Wiley Blackwell, vol. 66(4), pages 529-551, November.
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    5. Zeynep Burcu Ugur, 2015. "Does Presumed Consent Save Lives? Evidence from Europe," Health Economics, John Wiley & Sons, Ltd., vol. 24(12), pages 1560-1572, December.
    6. Tinglong Dai & Ronghuo Zheng & Katia Sycara, 2020. "Jumping the Line, Charitably: Analysis and Remedy of Donor-Priority Rule," Management Science, INFORMS, vol. 66(2), pages 622-641, February.
    7. Michael P. Murray, 2006. "Avoiding Invalid Instruments and Coping with Weak Instruments," Journal of Economic Perspectives, American Economic Association, vol. 20(4), pages 111-132, Fall.
    8. Fırat Bilgel, 2012. "The impact of presumed consent laws and institutions on deceased organ donation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 29-38, February.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 8th February 2021
      by Rita Faria in The Academic Health Economists' Blog on 2021-02-08 12:00:01

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    More about this item

    Keywords

    Organ donation; Relative consent; Family veto; European countries; Presumed consent;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • Z1 - Other Special Topics - - Cultural Economics

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