Emotions, Recipient Factors, and Different Organ Donation Types: An Experimental Investigation of Disgust and Health Anxiety

Abstract

Posthumous organ donation and transplantation is a life-saving intervention for people with organ failure. However, the number of organs needed outweighs the number available, both worldwide and in New Zealand. Family refusal (lack of proxy consent) is among biggest barriers to donation, as families refuse 50% of viable transplants (Hyde & White, 2010). The origins of refusal are unclear with most work being correlational and concentrated on demographics in the context of self donation. Given that emotions are arguably the biggest driver of human behaviour and decisionmaking (Consedine & Moskowitz, 2007), emotions provide a credible and promising avenue for investigation. Common elicitors of disgust and health anxiety are present in organ donation contexts (e.g. illness, death, surgery) making the relevance of these emotions likely. The current thesis experimentally examined whether disgust and health anxiety influence donation decisions, and whether recipient factors and different types of organ donation also predict or moderate these effects. Ninety-nine participants completed a web-based questionnaire assessing demographics, donation attitudes, and personality factors. Participants were then gender block randomised to control, disgust, or health anxiety conditions, in which they attended a 30-minute laboratory session. Participants completed eight organ donation vignettes, each outlining a scenario where self, family, or proxy donation was possible, and rated the likelihood that they would authorise each donation. Disgust and health anxiety were successfully manipulated, but neither emotion independently predicted donation ratings. As expected, negative donation attitudes predicted lower donation ratings and moderated the effect of induced disgust. Consistent with prediction, ratings were higher for self versus proxy or family donation ratings (and proxy ratings were higher than family ratings). Participants gave higher ratings to both positively presenting and less accountable recipients; additional interactions were also evident. Overall, findings provide novel, experimental evidence that the determinants of organ donation decisions involve emotions, but that their causal impact is unclear and may be moderated by both dispositional attitudes and recipient factors. Findings and effect sizes are interpreted in light of prior research, and implications for addressing negative perceptions regarding donation and the differences between different types of donation decisions are noted.