'Nudging' registration as an organ donor: implications of socio-cultural variations in knowledge and attitudes

Thaler and Sunstein’s behavioural economics theory of ‘Nudge’ aims to achieve beneficialoutcomes for individuals and the society through designing the contexts in which choices are made rather than relying on traditional policy levers of restrictions, penalties and education. We examined Nudge strategies to increase registration as a deceased organ donor among minority ethnic groups based on 22 focus groups that were held with Black and South Asian ethnic minorities in London (UK).This identified ways in which ethnic minorities’ habitus and predisposed dispositions appeared to limit both awareness and knowledge of the system of organ donation and shaped attitudes to registration, with variations in faith/culture and trust in professionals having particular significance. This questions a key requirement of Nudge’s libertarian dimension and also suggests that focusing solely on the immediate choice context and neglecting individuals’ prior dispositions may not achieve desired outcomes for socially heterogeneous populations.