Is Potential Regret a Greater Motivator for Action Than Potential Benefit?

The simple answer to this question is, at present, we don’t know.

What we do know is that when we compare people registered as organ donors with those who are not registered (in both the United States and the United Kingdom), they differ on a number of important variables, including perceptions of perceived benefit. However, they also differ on a number of other significant variables, such as the “ick” factor, a basic disgust reaction to the thought of organ donation, and the “jinx” factor. Jinx factors are those that are related to fears, anxieties, and superstitions about the misfortune that would result if a person registered as an organ donor or actually donated his or her own organs. While many people recognize that their fears may be irrational, they still act as important barriers to people becoming organ donors. Many people feel extremely uncomfortable when considering their own mortality. Here is an illustrative quotation from someone who is not an organ donor:

I’m 22 years old and don’t get me wrong, I think organ donation is an amazing thing and I admire greatly those people who do it. I’m not yet on the organ donation list, and I know this sounds stupid and pathetic and I feel incredibly guilty about it, but I think it’s because I don’t want to face my own mortality. … To contemplate the whole situation makes me very worried and also very sad, but every time I see an advert about it I feel even worse as a person and incredibly guilty!

The sad fact is that these emotional beliefs result in many people dying while they await an organ transplant.

Several studies have been conducted that aim to target these emotional factors. Asking people to seriously contemplate the regret they may feel if they did not perform an action has shown promising results. For example, attendance at cervical screening (pap smear) appointments is significantly increased if questions are included in the invitation letter asking the person how she would feel if she did not attend and later developed cervical cancer. We have also shown a similar effect in increasing intention and self-reported registration as a posthumous organ donor. We are just about to start a study in the United Kingdom where we test whether a simple anticipated regret manipulation leads to a significant increase in verified organ donor registrations.

We believe that more research is urgently needed to test methods of increasing organ donor registrations. One avenue that may prove profitable is to focus on the positive rather than the negative—that is, highlight the perceived benefits of organ donation. A simple intervention focusing on the perceived benefits would be welcome. Following Susan Morgan’s important work in the United States, we have measured perceived benefit using items such as “Organ donation allows something positive to come out of a person’s death” and “Organ donation helps bring meaning to the death of a loved one”. Finally, Eamonn Ferguson and his colleagues in Nottingham have shown that perceived benefit to the self is also an important component of blood donating behavior. That is, as well as helping recipients, the act of blood donation makes donors feel better about themselves. We should conduct further research investigating the impact of highlighting the perceived benefit to recipients, and potential donors (and their families), to test whether this could significantly increase organ donor registration rates.

Ronan O’Carroll is a professor of psychology at the University of Stirling and the president of the UK Society for Behavioural Medicine.

Category: Q&A

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