How Default Choice and Priority Rule Affects Organ Donation: An Examination of Hypotheses

This paper develops a theoretical model to show how changes in the default system of organ donor registration, along with a Priority Rule, affect society's cadaveric organ donation rate. The developed model is on the lines of Kessler and Roth (2012) and seeks to inspect the hypotheses put forward by Li et al (2013), solely based on their laboratory experiment. The model shows that some of these results can change under specific assumptions regarding the population of potential donors. Among the hypotheses examined in this paper, special emphasis has been given to hypothesis 4, which evaluates whether a nation benefits more from the introduction of the priority rule compared to a change in the default system of organ donation to presumed consent, when the baseline system is explicit consent without the priority rule. The findings suggest that the outcome of such an analysis, in an economy like the United States, will critically depend on how one chooses to quantify the monetary value of Quality Adjusted Life Years (QALYs) gained from organ transplantation and the transaction cost of donor registration. The paper highlights that in the year 2016, the US would have benefited relatively more, in terms of donor registrations for deceased kidney donation, from a change in the default system of organ donation to presumed consent rather than an introduction of the priority rule. This result holds as long as the monetary value of a QALY gained from Deceased Kidney Transplantation is less than $2,068,717.04, at 2016-level prices. The robustness of this result has been confirmed through Monte Carlo Uncertainty Analysis, with statistical significance at the 99 % level.