The Role of Self- and Other-Oriented Motivation in the Organ Donation Decision

ABSTRACT - The purpose of the present study was to compare the effects of self- and other-oriented public service announcements on undergraduates' attitudes toward kidney donation and their expressed willingness to donate their own or a loved one's kidneys upon death. In contrast to the results of prior survey studies of individuals' motives for donating, subjects were found to respond more favorably to a message that emphasized benefits to the self than to a message that emphasized benefits to the other. Some possible explanations for the present findings are discussed.

Citation:

Mark A. Barnett, Michael Klassen, Vera McMinimy, and Laurel Schwarz (1987) ,"The Role of Self- and Other-Oriented Motivation in the Organ Donation Decision", in NA - Advances in Consumer Research Volume 14, eds. Melanie Wallendorf and Paul Anderson, Provo, UT : Association for Consumer Research, Pages: 335-337.

Advances in Consumer Research Volume 14, 1987      Pages 335-337

THE ROLE OF SELF- AND OTHER-ORIENTED MOTIVATION IN THE ORGAN DONATION DECISION

Mark A. Barnett, Kansas State University

Michael Klassen, Kansas State University

Vera McMinimy, Kansas State University

Laurel Schwarz, Kansas State University

[Correspondence should be sent to Mark A. Barnett, Department of Psychology, Kansas State University, Manhattan, Kansas 66506.]

ABSTRACT -

The purpose of the present study was to compare the effects of self- and other-oriented public service announcements on undergraduates' attitudes toward kidney donation and their expressed willingness to donate their own or a loved one's kidneys upon death. In contrast to the results of prior survey studies of individuals' motives for donating, subjects were found to respond more favorably to a message that emphasized benefits to the self than to a message that emphasized benefits to the other. Some possible explanations for the present findings are discussed.

INTRODUCTION

There is a serious shortage of organs available for transplantation in this country. For example, the American Council on Transplantation estimates that although nearly 7,000 kidney transplants were performed in 1984, there were approximately 8,000 patients awaiting a kidney at the end of the year. A potential kidney transplant recipient may wait for years before an appropriate match (with regard to size, tissue, and blood type) is found. Unfortunately, the longer a person waits, the more likely a new organ will be rejected.

As organ transplantation has become a more common medical procedure, there has been a growing interest in studying people's attitudes and knowledge concerning organ donation (Belk and Austin 1986; Fellner and Marshall 1981; Manninen and Evans 1985; Overcast, Evans, Bowen, Hoe and Livak 1984; Pessemier, Bemmaor and Hanssens 1977; Prottas 1983). Organ donation is a particularly interesting topic from a psychological perspective because it involves a unique kind of helping behavior that has obvious and serious consequences on the lives of others. In addition, although most people express favorable attitudes toward organ donation, very few perform the behaviors that are necessary to donate, such as signing an organ donor card or talking with family members about their desire to donate (Manninen and Evans 1985; Overcast et al. 1984; Prottas 1983). As suggested by Prottas's (1983) discussion of "the marketing of organ donation", we need to increase our understanding of people's motives for donating (or not donating) and to investigate procedures for increasing the rate of donation.

The literature on helping behavior may provide a useful framework for conceptualizing the motivation to donate human organs. Many theorists and researchers in the helping area (Barnett in press; Batson and Coke 1981; Eisenberg 1982; Karylowski 1982) have distinguished between self and other-oriented concerns in the decision to assist another individual. In a similar vein, Sojka (1985) has recently suggested that monetary donations to non-profit organizations can be viewed as being motivated by altruistic (i.e., other-oriented) or non-altruistic (i.e., self-oriented) concerns. It is our contention that the self versus other motivation distinction may also prove to be a useful one in understanding the organ donation process and in influencing individuals' decisions to donate.

The purpose of the present study was to compare the effects of self- and other-oriented public service announcements (PSA) on undergraduates' attitudes toward kidney donation. Since the next-of-kin frequently play a critical role in the organ donation process (Overcast et al. 1984; Prottas 1983), we also asked subjects to role-play a relative who must make the donation decision for a dying loved one (whose own wishes concerning organ donation were presumably unknown). Thus, questions concerning an individual's willingness to donate his/her own and a loved one's kidneys upon death were included on the questionnaire. We also attempted to examine the influence of individual differences in empathy on responses to the self- and other-oriented PSA. The helping behavior of a highly empathic individual, in contrast to a less empathic individual, is believed to be activated by a predominately altruistic motive (e.g., Batson and Coke 1981). Therefore,we expected that highly empathic individuals would be more responsive to the other-oriented PSA than would their less empathic counterparts.

METHOD

A total of 77 undergraduates (38 males and 39 females) enrolled in General Psychology at Kansas State University received course credit for their participation in this study. Subjects were run in small groups and were led to believe that they were taking part in two independent studies conducted during a single testing session.

In the "first" study, a female experimenter told subjects that they would be asked to complete a questionnaire after listening to a brief public service announcement (PSA) being test marketed by the (fictitious) National Kidney Association. In fact, there were two versions of the PSA: one tape stressed self-oriented reasons for donating; the second tape stressed other-oriented reasons for donating (extensive pretesting of the PSA messages with undergraduates affirmed that the self- and other-oriented tapes were perceived as such). The script for the other-oriented PSA read as follows:

This is Jerome Kennedy, speaking for the National Kidney Association.

Between 1954 and 1985, over 76,000 kidneys were donated in this country. Although these numbers are encouraging, there remains a shortage of kidneys available for transplantation. The Center for Disease Control estimates that no more than 15: of deceased individuals who could serve as donors actually do so. This is in spite of the fact that the donor, or his or her family, are never asked to pay any costs related to the donation of the kidney. All costs are paid by the National Kidney Association in cooperation with a regional organ bank.

I would like you to take a few moments to consider the decision to donate.

--Few decisions in your life will have such a dramatic effect on the lives of others.

- A donated kidney provides immeasurable benefit to those who receive the donation.

--It will help others overcome a debilitating and potentially life-threatening kidney disease.

- Just imagine how they will feel to be healthy and to live a normal life once again with their family and friends.

Please consider the decision to donate. Do it for them. Thank you.

The initial portion of the self-oriented PSA was identical to the other-oriented PSA; however, the self-oriented PSA concluded in the following manner:

I would like you to take a few moments to consider the decision to donate.

--Few decisions in your life will be as meaningful to you as this one.

--Donating can be extremely beneficial to you, the person who makes the positive decision to donate.

--It is an important personal decision that will make you feel better about yourself and will say something very positive about you as an individual.

--People who learn of your decision will undoubtedly think of you as a good and caring person.

Please consider the decision to donate. Do it for yourself. Thank you.

After listening to one of the two PSA tapes, subjects completed the "Kidney Donation Questionnaire" (see Table 1).

TABLE 1

QUESTIONS INCLUDED ON THE KIDNEY DONATION QUESTIONNAIRE

This questionnaire contained 11 items; for each item, subjects responded to a 9-point scale ranging from 1 (reflecting a very unfavorable rating) to 9 (reflecting a very favorable rating). The first three items required each subject to rate (1) how understandable the PSA was, (2) how effective it would be in getting people to think about the issue of kidney donation, and (3) how clearly presented the reasons for donating were. The remaining eight items asked about changes in the subject's attitude toward kidney donation and the likelihood of donating in response to hearing the PSA. Some of these latter questions required subjects to role-play a potential donor (whose commitment to donating would be confirmed by signing the back of his or her driver's license or an appropriate organ donation card). Some of the questions required subjects to role-play the next-of-kin who might be asked to make a decision about donating the kidneys of a relative (such as a child or parent) upon his or her death.

Following the completion of the questionnaire, subjects were thanked for their assistance and introduced to another female experimenter who was to conduct the "second" study. Subjects were told that the purpose of the "second' study was to gather data on a new questionnaire assessing particular social reactions. In fact, subjects completed the Mehrabian and Epstein (1972) empathy measure, a 28-item questionnaire tapping individuals' emotional responsiveness to the feelings of others. On this questionnaire, subjects are asked to indicate the degree to which they agree or disagree with each statement (e.g., "It makes me and to see a lonely stranger in a group") by circling one number on a 9-point scale following each statement. After completing this questionnaire, subjects were fully debriefed and thanked for their participation.

RESULTS

Subjects' responses to the "Kidney Donation Questionnaire" were analyzed by a multivariate analysis of variance (MANOVA) and subsequent univariate analyses of variance (ANOVAs). The MANOVA revealed a significant effect of Type of PSA, F (11, 63)-2.08, p < .05. Although subjects indicated that the reasons for donating were more clearly presented in the other-oriented (M-7.23) than self-oriented (M-6.05) PSA [F (1, 73)=12.70, p < .0011, they generally responded more favorably to the latter message. In fact, for all 8 questions dealing with attitudes toward and willingness to donate, the mean ratings for the self-oriented PSA were higher than those for the other-oriented PSA. Interestingly, the tendency to favor the self-oriented PSA was found to be most marked for the item concerning subjects' willingness to donate their own kidneys upon their death [Ms for the self-oriented and other-oriented PSAs were 6.97 and 6.28, respectively; F(1, 73)= 4.68, g < .05].

No relation was found between subjects' empathy scores on the Mehrabian and Epstein (1972) measure and subjects' ratings on the Kidney Donation Questionnaire.

DISCUSSION

In general, the subjects' responses indicated that they(1) had a more favorable attitude toward kidney donation and (2) expressed a greater willingness to donate their own or a loved one's kidneys upon death after hearing a self-oriented than an other-oriented PSA promoting kidney donation. Unexpectedly, the greater responsiveness to the self-oriented PSA was found for high as well as low empathy subjects.

The general pattern of results reported here is inconsistent with the results of prior survey and anecdotal studies (Cleveland 1975; Fellner and Marshall 1981; McIntyre, Barnett, Harris, Shanteau, Skowronski, and Klassen 1987; Moores, Clarke, Lewis and Mallick 1976; Prottas 1983) indicating that people express motives for donating organs that are primarily other-oriented and altruistic. How can one account for the present findings given the abundance of contrasting reports?

The results of prior studies may reflect the tendency of individuals to report socially desirable (i.e., other-oriented) responses. Such biases may be expected to play a significant role in survey and anecdotal studies that ask people about their willingness and motive to help. In contrast, an experimental manipulation of motives for helping (such as used here) may serve to "camouflage" the socially desirable response, especially in a between-subjects design wherein a direct comparison of the "good" and "bad" motives is not salient. As suggested by Batson, Bolen, Cross and Neuringer-Benefiel's (1986) recent experiment, people's motives for helping (when not directly solicited) may often reflect egoistic rather than other-oriented concerns.

Research on individual's reluctance to donate organs may also provide some insight into the present pattern of results. In a recent report, Belk and Austin (1986) concluded that "a barrier to organ donation is the fear that to do so will diminish the self, even after death." Perhaps the self-oriented PSA was found to be an especially persuasive message precisely because it emphasized an enhancement, rather than a diminution, of the self. In this regard, it might prove interesting to assess the impact of a self-oriented PSA on individuals previously determined to be high or low in self-concerns associated with organ donation.

Another possible explanation for the present results concerns the finding that the reasons for donating were rated as significantly clearer in the other-oriented than self-oriented PSA condition. Perhaps, the self-oriented message was unexpected, required more processing and, as a result, proved to be more influential. This notion, while highly speculative, is consistent with studies (e.g., Chaiken and Baldwin 1981; Craik and Lockhart 1972) suggesting that persuasive messages that require "deeper processing" may be more conducive to attitude change than simpler, expected messages requiring little or no cognitive processing.

Perhaps we should not be too surprised with the finding that people respond favorably to self-oriented PSAs because much of advertising appeals to self-interest (people presumably are quite responsive to the described benefits to-themselves of a particular toothpaste, soap, or similar product). Future research in this area could compare and contrast the impact of a self-oriented message with other "kinds" of messages (emphasizing norms of giving and helping, for example). It might also prove fruitful to explore the effect of combining two or more "motives" in a single message. Finally, future studies could examine the mediating role of other individual difference variables besides empathy (e.g., religiosity) on individuals' responses to various donation-promoting messages. The results of such research efforts are certain to be of interest to those organizations and individuals concerned with promoting organ donation and donation behavior in general.

REFERENCES

Barnett, Mark A. (in press), "Children's Perceptions of Others' Motives for Helping in Same- and Opposite-Sex Dyads," Journal of Genetic Psychology.

Batson, C. Daniel, Michelle H. Bolen, Julie A. Cross and Helen E. Neuringer-Benefiel (1986), "Where is the Altruism in the Altruistic Personality?" Journal of Personality and Social Psychology, 50 (January), 212-220.

Batson, C. Daniel and Jay S. Coke (1981), "Empathy: A Source of Altruistic Motivation for Helping?" in Altruism and Helping Behavior, eds. J.P. Rushton and R. M. Sorrentino, Hillside, NJ: Erlbaum Associates.

Belk, Russell W. and Mark C. Austin (1986), "Organ Donation Willingness as a Function of Extended Self and Materialism," in Advances in Health Care Research, ed. M. Ven Venkatesen. Association for Health Care Research.

Chaiken, Shelly and Mark W. Baldwin (1981), "Affective-Cognitive Consistency and the Effect of Salient Behavioral Information on the Self-Perception of Attitudes," Journal of Personality and Social Psychology, 41(July), 1-12.

Cleveland, S. (1975), "Personality Characteristics, Body Image and Social Attitudes of Organ Transplant Donors Versus Non-Donors," Psychosomatic Medicine, 37(July-August), 313-319.

Craik, Fergus I. M. and Robert S. Lockhart (1972), "Levels of Processing: A Framework for Memory Research," Journal of Verbal Learning and Verbal Behavior, 11(December), 671-684.

Eisenberg, Nancy (1982), "The Development of Reasoning Regarding Prosocial Behavior," in The Development of Pro- social Behavior. ed. Nancy Eisenberg, New York: Academic Press.

Fellner, Carl H. and John R. Marshall (1981), "Kidney Donors Revisited," in Altruism and Helping Behavior, eds. J. P. Rushton and R. M. Sorrentino, Hillsdale, NJ. Lawrence Erlbaum Associates.

Karylowski, Jerzy (1982), "Two Types of Altruistic Behavior: Doing Good to Feel Good or to Make the Other Feel Good," in Cooperation and Helping Behavior: Theories and Research, eds. V. Derlaga and J. Grzelak, New York: Academic Press.

Manninen. Diane L. and Roger W. Evans (1985), "Public Attitudes and Behavior Regarding Organ Donation," Journal of the American Medical Association, 253(June), 3111-3115.

McIntyre, Patricia. Mark A. Barnett, Richard J. Harris, James Shanteau, John Skowronski and Michael Klassen (1987), "Psychological Factors Influencing Decisions to Donate Organs," in Advances in Consumer Research, eds. Melanie Wallendorf and Paul Anderson, Provo, Utah: Association for Consumer Research.

Mehrabian, Albert and Norman Epstein (1972), "A Measure of Emotional Empathy," Journal of Personality, 40 (December), 525-543.

Moores, B., G. Clarke, 8. R. Lewis and N. P. Mallick (1976), "Public Attitudes Towards Kidney Transplantation," British Medical Journal, 13 (March), 629-631.

Overcast, Thomas D., Roger W. Evans, Lisa E. Bowen, Marilyn M. Hoe and Cynthia L. Livak (1984), "Problems in the Identification of Potential Organ Donors," Journal of t American Medical Association, 251(March), 1559-1562.

Pessemier, Edgar A., Albert C. Bemmaor and Dominique M. Hanssens (1977), "Willingness to Supply Human Body Parts: Some Empirical Results," Journal of Consumer Research, 4 (December), 131-140.

Prottas, Jeffrey M. (1983), "Encouraging Altruism: Public Attitudes and the Marketing of Organ Donation," Health and Society, 61(2), 278-306.

Sojka, Jane R. Ziegler (1985), "Understanding Donor Behavior: A Classification Paradigm," in Advances in Consumer Research, ed. Richard J. Lutz, Provo, Utah: Association for Consumer Research. 240-245.

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