Is family-priority rule the right path? An experimental study of the Chinese organ allocation system

We experimentally test the effectiveness of the family-priority allocation rule on organ donation and argue that such incentive would be highly motivating in Chinese family-oriented culture.Three different allocation conditions were implemented in the experiment, including the Control condition, the Self-priority condition, and the Family-priority condition. The experiment was performed at the Center for Economic Behavior and Decision-making (CEBD) of Zhejiang University of Finance and Economics in China.16 Subjects were recruited from the college student body through a recruiting program on WeChat that randomly invites registered subjects to participate in the experiment. A total of 720 subjects participated in the experiment .

2020-06-17

2022-06-16

Results of our experiment show that introducing the family-priority rule can significantly increase the donation rate. The family-priority rule can not only increase donor registration but also promote family consent. As expected, the self-priority rule generates a loophole so that subjects can register as organ donors to receive the priority but not actually donate. Such loophole eliminates the incentives created by the priority rule and leads to zero increase in donation. We also find that the efficacy of the family-priority rule varies across different levels of family connections. When in a family-oriented culture setting, like that of China, the familypriority rule is very effective. When in a loose family connection setting, the impact on donor registration reduces, but it still has a positive impact on family consent, as it provides direct incentive to family members of donors.

We also study the effect of information in our experimental setting. Results of our experiment show that providing individuals additional information about the donation process does not have a significant impact on either donor registration or family consent.

We adopted the design of Kessler and Roth (2014) as the basic experimental structure. Each subject played the role of a virtual human with one A organ and two B organs in the experiment. Each round of the experiment, each subject was endowed with 8 Chinese Yuan (approximately 1.3 US Dollars) and could earn additional 8 Chinese Yuan if he maintained one active A organ and at least one active B organ at the end of that round. Each round, each subject received a health outcome of either A-organ failure or B-organ failure. If a subject had A-organ failure, he could not earn any more money in that round but could donate his B organs to subjects in need. If a subject had B-organ failure, both of his B organs failed and he could receive a B organ donated by another subject to earn more money in that round.
We modified the design by introducing the concept of family in our experiment. Each session of the experiment contains 16 subjects. Subjects were randomly divided into two fixed groups of 8 players.
Each subject was randomly matched with one subject from another group to form a “family” and the family match stay fixed through the experiment. Family members shared each other’s net gains in each round with a certain ratio to resemble connections between family members in real world.
Three different allocation conditions were implemented in the experiment, including the Control condition, the Self-priority condition, and the Family-priority condition.

By a computer.

individual

Yes

The experiment was performed at the Center for Economic Behavior and Decision-making (CEBD) of Zhejiang University of Finance and Economics in China. Subjects were recruited from the college student body through a recruiting program on WeChat that randomly invites
registered subjects to participate in the experiment. A total of 720 subjects participated in the experiment.

720 subjects.

We set up 9 treatments:the Control condition(Standard setting 𝛼=0.5);the Control condition (Information setting 𝛼=0.5); the Self-priority condition (Standard setting 𝛼=0.5);the Self-priority condition (Information setting 𝛼=0.5);the Family-priority condition(Standard setting 𝛼=0.5); the Family-priority condition(Information setting 𝛼=0.5);the Family-priority condition(Standard setting 𝛼=1);the Family-priority condition(Standard setting 𝛼=0.75) and the Family-priority condition(Standard setting 𝛼=0.25). In Each treatment,there are 5 Sessions, including a total of 80 participants.