Implicit attitudes to organ donor registration: altruism and distaste

Abstract

Organ transplantation offers patients cost-efficient quality-of-life improvements and life-saving opportunities. In England, the majority of transplants emanate from cadaver donation in a system where would-be-donors register their agreement to donation. Despite the majority of the population stating approval of organ donation, only a minority register as a donor. Research has traditionally examined explicit attitudes, typically demonstrating how distaste limits the translation of altruism into behaviour. In contrast, this study explored the relationship of implicit as well as explicit altruistic and distaste attitudes to donor register status. A cross-sectional study employed a novel approach to the measurement of implicit attitudes as participants (N = 166, mean age 22 years) completed a Single-Category Implicit Association Test (SC-IAT) on organ donation with two separate components – one examining implicit altruistic attitudes and another examining implicit distaste attitudes. Explicit altruistic and explicit distaste attitudes were measured via a questionnaire, as was organ donor register status. Multinomial logistic regression investigated the relationship of register position to altruistic and distaste explicit and implicit attitudes, gender and age, and established that those intending to register (33%) and those who did not intend to register (30%) were differentiated from those already registered (37%) in a number of ways (LRx2 = 84.22, df 12, p < .001). Explicit altruistic attitudes were very positive among all three groups. Negative explicit distaste attitudes were especially characteristic of those who did not intend to register. Implicit distaste attitudes did not vary by register status, but negative altruistic implicit attitudes were more commonly found among those intending to register than among the registered. Men were under-represented on the register, and over-represented among those intending to register. The results are relevant for donation propaganda indicating the possibility that among intenders, registration may be limited more by ambivalent altruism than by distaste.

Keywords

• Implicit attitudes
• altruism
• distaste
• organ donation
• single-category IAT