Organ donation policy

According to a report in the UK's Daily Telegraph, the UK government's Organ Donation Taskforce is about to recommend that the UK does not move to a system of presumed consent, claiming that people are not ready for such a move. In a system of presumed consent, all people would be assumed to be willing to allow their healthy organs to be used to help others in the event of their death, unless they had explicitly indicated that they did not want their organs to be used in this way. The current system assumes the opposite; people must explicitly indicate that they are willing to allow their organs to be used.

The UK has a persistent shortage of organ donors. The Chief Medical Officer Liam Donaldson has criticised the conclusion of the taskforce, saying "People are dying, people are suffering and many people are living on a knife edge of despair, waiting for a phone call that never comes".

It is true that a system of presumed consent, by itself, is not a cure-all for the problem of organ shortage, as the New Scientist recently noted (September 14, issue 2673). One key factor is the quality of communication between doctors and the families of potential donors, but this is clearly something that can be addressed by training. However, what is also clear is that - families aside - a system of informed consent does increase the number of individuals who are willing to allow their own organs to be used. In a Science article titled "Do defaults save lives", Eric Johnson and Dan Goldstein compared the rates of consent when an opt-in or an opt-out system was used. They did this with both an online experiment and by examining statistics from various countries. In both cases, the opt-out system generated far higher rates of consent (see for example the graph below).

Readers who wish to lobby their MP about this issue can obtain details of their MP and how to contact them electronically from the website They Work for You. Act quickly: the taskforce is due to report its conclusions formally on Monday 24th November.

Magazine subscriptions: Do the math!

In his book Predictably Irrational Dan Ariely notes an unusual range of subscription offers by the Economist magazine: (1) a web subscription for $59, (2) a print subscription for $125, and (3) a print and web subscription for $125. Somehow, option (3) sounds better in the context of option (2) as it sounds as though you are getting the web subscription for free. Ariely goes on to discuss how preferences in general are constructed within a particular context.

The Economist is no longer advertising the above offer (perhaps as a result of Ariely's book?). However, they now have another bit of canny framing. The current options (in the UK) are described as follows:

(1) BEST OFFER: £12 for your first 12 issues saving 74% on the cover price. Then £27 per quarter (13 issues) thereafter.
(2) 1 year for just £93, saving 53% on the cover price with Direct Debit or Credit Card.
(3) 3 years for just £216, saving 64% on the cover price with Credit Card.

At the time of writing, the cover price for The Economist is £3.90. So the best offer has a saving of 74%, compared to the 64% saving for the 3 years subscription, and 53% for the straightforward annual subscription. Right? Well, not quite. Bear in mind that there are a total of 51 issues per year - one per week, except for the Christmas period when there is a double issue to cover a fortnight. So the "best offer" is in fact a year's complete subscription (12 issues plus 3 x 13 issues). And the total price for this "best offer" is £12 + 3 x £27 = £93. In other words, the best offer is just the same as the second offer. Both are basically a year's subscription. The 74% saving in (1) only applies to those first 12 issues, not to the yearly subscription overall.

In total monetary terms, the 3 year subscription offers the best saving, except - as my colleague Peter Ayton points out - you are essentially lending money to the Economist by paying up front. Nonetheless, if you are a regular weekly purchaser then the size of the discount eclipses the interest you would make by keeping the equivalent amount of money in the bank and buying on a weekly basis, especially bearing in mind likely increases in the cover price within the 3 year period.