New 'body of evidence' regarding approval of prostitution, compensation for organ donation

Selling one's body to provide another person with sexual pleasure and selling organs to restore another person's health are generally prohibited in North America on moral grounds, but two new University of Toronto Mississauga studies illustrate how additional information about the societal benefits of such transactions can have an impact on public approval.

The research, conducted by Professor Nicola Lacetera of the University of Toronto (Institute for Management and Innovation, U of T Mississauga, with a cross-appointment to the Rotman School of Management) and his colleagues Julio Elias from Universidad del CEMA in Argentina and Mario Macis from Johns Hopkins University in the United States and adds to our understanding of how moral considerations affect markets and business decisions.

A shortage of organ donors is a serious problem in the United States and Canada. South of the border, 120,000 people are on the waiting list for an organ transplant. Every year, only about 29,000 transplants are performed, and over 10,000 people die—or become too sick for a transplant—while on the waitlist. Americans view financial transactions to increase the supply of organs as immoral, even though previous research has indicated that payments of between $15,000 and $30,000 would close the gap between demand and supply and would have the added benefit of cost savings for stopgap treatments, such as kidney dialysis.

Lacetera and his colleagues surveyed 3,400 United States residents and chose to test assumptions about organ donation and indoor prostitution, because both were morally controversial and had similar baseline approval rates, and they assumed there might be spillover in approval from one to the other.

In a recent article published in the Papers and Proceedings of the 2015 Meetings of the American Economic Association (American Economic Review, May 2015), the researchers show that providing additional information about the lifesaving and cost-saving benefits of an organ market increased the approval rating of some form of payment by 20 percent to 70 percent from 50 percent, with no significant variation across age or gender.

'Attitudes toward organ payments may therefore not be completely fixed, given the response to evidence,' says Lacetera.

Yet the same can't be said for attitudes toward allowing indoor prostitution. When survey respondents learned that legalized indoor prostitution reduces violence against women and cuts the rates of sexually transmitted diseases, this didn't have much of an impact on their acceptance of the idea. In fact, among women, having more information led to a decrease in approval rates.

'Because values are so ingrained and so specific, you can't generalize from situation to situation,' Lacetera says.

A second study, appearing in PLOS ONE, demonstrated this inability to assume that acceptance of one morally controversial market transaction naturally means acceptance of all. The researchers used again a survey instrument to test blanket acceptance by providing them with information about one type of transaction (e.g., prostitution), then testing their acceptance of another (e.g., organ donation).

Approval ratings for legalizing indoor prostitution didn't change, even when paired with information about the value of organ donations. These results suggest that U.S. residents' opinions regarding indoor prostitution are relatively stable, and are not affected by cost-benefit considerations; they are based on deeply held moral values.

However, among women, any mention of the benefits of indoor prostitution paired with questions about organ donation led to a radical drop—30 percent—in their approval for the latter type of transaction, leading to a statistically significant drop in approval overall. The researchers noted that this isn't surprising, given the 'existing literature documenting the deep opposition of women toward a market for sex, plausibly triggered by associations of prostitution with stigmatization, sexual dominance and women's oppression.'

'These results imply that the provision of well-supported information can change attitudes toward the acceptance of morally charged market trades but the information has to be context-specific,' Lacetera says. 'Information about the benefits of paying for such transactions must be directly relevant to the transaction, and even then, a change in attitude depends on the type of transaction being discussed.'

'Our research should provide information to policymakers as they devise ways to solve shortages of goods and services whose trades is morally charged, and should also remind companies that attitudes toward certain trades are also affected by moral considerations,' he says. 'This, in turn, may affect the economic prospects of a company in a given context.'