News and Comment

Moving the goal posts: the way in which citizens consent to certain policies is changing

Friday 5 July 2013

It used to be that if you wanted a pension you got one by enrolling on a scheme. Similarly, if you wanted to become an organ donor you did so by filling out the requisite expressions of intent. But of late, the way in which we consent to such actions has begun to change, with the onus in some circumstances now on us to ‘opt-out’ rather than ‘opt-in’.

Since last October in the UK the vast majority of workers will now be automatically enrolled on a workplace pension scheme. And from 2015, adults who live in Wales will be signed onto the organ donor register as a matter of course, unless they specify otherwise.

Though pensions and transplants ostensibly have very little in common, the changes to their enrolment systems stem from one glaring similarity: not enough people were participating.

Shortly before the October 2012 change, an ONS poll found that just 32% private sector workers contributed to a pension scheme. Since that time Aviva research has found that just 37% plan to opt-out of the schemes they are automatically enrolled onto. On organ donation opinion polls have consistently shown that 70% of us are in favour of being on the register, but only 31% of us are in fact signed up – a figure too low by far to meet demand.

This disparity between what we know to be best and what we do anyway is often described as status quo bias: a cognitive preference for the current state of affairs which affects individuals’ decision-making. In practice this means that people are often unwilling to take change-making decisions, even if they believe those changes will be positive or beneficial.

For this reason the British Government and Welsh Assembly decided to revise the way in which they seek the approval of the public on these issues – moving from an ‘opt-in’ model of explicit consent, to an ‘opt-out’ model of presumed consent. As a result, participation in private pension schemes has already increased and numbers on the organ donor register are also expected to rise.

In many respects this could be seen as another success inspired by ‘nudge theory’ – the Government gently encouraging its citizens to make decisions which coincide with the state’s preferred outcomes (saving, donating etc.). But it is also a development that poses a number of ethical dilemmas which should concern those interested in public participation and engagement. For instance, is presumed consent the same as explicit consent? And does acting on our behalf in this way alter the dynamic between citizen and state?

Whilst impassioned arguments continue regarding the Welsh switch from an ‘opt-out’ to ‘opt-in’, a pragmatic consensus is building that since this decision has been made, a great deal of work is required to inform the public about it. This point is crucial. The ‘opt-out’ system is predicated on awareness. It is not intended to increase the numbers of organ donors by stealth and there can only be a genuine presumption of consent if people know what they are consenting to (or indeed that they have in fact consented). Between now and 2015 Welsh residents should expect a concerted public information campaign regarding the change.

Such efforts make me wonder if a trick has been missed to implement something less complex and controversial. In the US a number of states have adopted the so-called ‘mandated choice’ approach, forcing drivers (at the point of their driving license renewal) to make a decision as to whether they do or don’t want to be an organ donor. The UK currently operates what’s known as a ‘prompted choice’ version of this system, in which drivers are asked whether they’d wish to donate but given an option, “not to answer this question now”.

As is well known in research, the way in which a question is framed can have a significant impact on the answer that is given. And, as the status quo bias tells us, if you know in certain circumstances that people are more likely to do nothing, changing the outcome of inactivity will lead to markedly different outcomes. This begs a further question:  is manipulating our behavioural preferences in this way good policy making, or dubious ethical practice?

The OPM Group Council will be exploring the changing relationship between citizen and the state over the next year. Please check out our blog for updates.