Organ Donation Is a Market Problem—and Facebook May Have Just Solved It

Facebook may have just solved a stubborn -- and heartbreaking -- public-health problem.

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This morning, Facebook announced a new initiative

Starting today, you can add that you're an organ donor to your timeline, and share your story about when, where or why you decided to become a donor. If you're not already registered with your state or national registry and want to be, you'll find a link to the official donor registry there as well.

First, it should be said: This is a canny PR move -- one that frames Facebook not just as a connector of people, but as an agent of empathy. The timing of the announcement itself, it's hard not to notice, is particularly auspicious (or suspicious?): Facebook is anticipating that its IPO documents will get approval this week, after which Zuckerberg and his fellow executives will begin actively selling the company to potential shareholders. So.

On the other hand, though: This is a canny PR move. The advent of the organ donor designation is an effort to publicize a problem, to use Facebook's increasingly enormous platform to get the word out about something whose social good is pretty much inarguable. The publicity is the point. And if goodwill accrues to Facebook in the process, well, great -- that will encourage the company to keep thinking of ways to marry its network's utility with net utility. It's not hyperbole to say that the organ donor option could see Facebook systematically saving lives -- and solving a conundrum that has long plagued not only patients and doctors, but social scientists. 

At its core, organ donation is a market problem -- one that carries a high degree of discrepancy between demand (those seeking organs) and supply (those who, preemptively, agree to provide them). It's that divide that leads to the heartbreaking statistics: More than 114,000 people in the United States, and millions more worldwide, are waiting for heart, kidney, or liver transplants. And an average of 18 people a day will die while waiting for organs to become available.

It's useful, from that perspective, to think about organ donation the way Harvard professor Nicholas Christakis does: in terms of cascades. In the book Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives, Christakis and his co-author, UCSD professor James Fowler, consider networked organ donation as a cascade not of information or of violence, as in the most classic senses, but of kindness. If I have a relative whose life is saved by a donated organ, I'm much more likely to become a donor myself -- as are my other relatives. And we're all more likely to encourage donation among our other social connections. So "you have a diffusion," Christakis told me. The gratitude radiates. Empathy itself takes on network effects.

The problem in the past has been that network effects tend to be limited, ironically, by the constraints of networks themselves. The word-of-mouth scenarios that have facilitated the organ donation cascade in the analog world mean that cascades can only go so far before they inevitably fade. That's why we can understand virality as a primarily digital phenomenon. And it's why Facebook's use of its platform to bring virality to organ donor registration could so significantly change the game when it comes to the social economics of organ donation -- and, potentially, of other forms of networked charity.

"I think it's great news that Facebook is going to encourage people to register as organ donors, and (maybe as important) to communicate to family and friends their intention," says Alvin Roth, an economics professor at Harvard who specializes in, among other things, market design and game theory -- both fields he has applied to his work with deceased donor kidney exchange. "We need to be facilitating all sorts of donation," he notes, "if we're going to turn the tide on the shortage of transplantable organs."

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Megan Garber is a staff writer at The Atlantic.

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