Web-based social networks have little in common with hospital operating rooms. One exists on an ephemeral realm of bits and bytes, while the other lives in the very real world of blood and tissue.
That incongruity helps explain why Facebook’s recent announcement that it will encourage its members to become organ donors captured people’s imagination. And according to psychologists who study how we manage reminders of our mortality, it suggests Mark Zuckerberg’s online creation may be a particularly promising platform to tackle a major medical problem.
“I think it’ll work better than any other strategy I’ve heard of to promote organ donation,” said Jamie Goldenberg, a researcher based at the University of South Florida. “Facebook could be a very safe way to approach a difficult subject.”
As Zuckerberg and Facebook’s Sheryl Sandberg noted in announcing the initiative, an average of 18 Americans die each day waiting for a heart, kidney or liver transplant. The problem is even greater in much of Europe, as The Economist recently reported. To get that number down, Facebook has created a simple way to add your organ-donor status to your Facebook page’s Timeline (under Life Event).
While there’s no way of verifying that people who tell their network they are potential organ donors have actually filled out the required paperwork, “We believe that by simply telling people that you’re an organ donor, the power of sharing and connection can play an important role,” Zuckerberg and Sandberg write.
The reality is actually not that simple. Facebook hopes to leverage its members’ desire to present themselves as good, likable, giving individuals—people who others would want to “friend.” But there are other psychological factors at play in such a delicate, personal decision.
By definition, agreeing to donate an organ requires contemplating that we’re going to die.
“That’s something people want to avoid thinking about,” said psychologist Tom Pyszczynski of the University of Colorado, Colorado Springs. He’s one of the fathers of Terror Management Theory, which explores how our beliefs and actions are shaped by our repressed fear of dying.
“When people do think about death, it often leads them to try to live up to the values they hold,” he noted. “If this [campaign to encourage sign-ups] is embedded in a ‘Be a good person’ appeal, the reminder-of-death element might actually increase the tendency of people to go along with it.”
“If people see all their friends are doing this and think, ‘Maybe I should too,’ that could have a broad-based benefit,” added the University of Virginia’s Matt Motyl. But he points to a 2008 study to show how easily such a campaign can backfire.
As part of that study, fliers were distributed on a college campus reading either “Are you concerned about death? We can help!” or “Are you dealing with back or muscle pain? We can help!” Pedestrians who received them were then solicited as potential organ donors. Those who had received the death reminder were significantly less likely to sign up.
“We want to view our body as a sacred vessel,” Motyl said. A doctor who cuts us open and extracts organs “is treating us as if we’re just a bunch of different parts put together.”
While contemplating being cut open is never going to be comfortable, “when people are given an opportunity to affirm their values and beliefs, they’re a little less vulnerable to the creep-out factor,” Pyszczynski said. “Facebook does that. If people were to update their status by asserting what they believe in, what’s important to them, it might make the idea of organ donation less threatening.”
“Facebook is infused with all sorts of meaning and vehicles for self-esteem—pictures of your kids, pictures of your paintings, etc.,” agreed Goldenberg. “You’re putting stuff up there that can have an impact on the world. This provides a defense against people’s feelings of insignificance. It’s a kind of symbolic immortality.”
There’s also an element of literal immortality, as Facebook pages can survive a person’s death. Pyszczynski noted that when a mentor of his died, a group of the man’s friends and former students created a posthumous Facebook page for him. As much terror management research has shown, the idea that we will live on in some way makes it at least slightly easier to think about our death—a prerequisite to considering organ donation.
The potential down side to this plan is that a significant percentage of people will take note of the organ donation indication, register the implications of death, and quickly banish both from their minds. Much research has found such subtle reminders of our mortality can shift the way we feel and act, at least on a short-term basis.
“It’s kind of a paradox,” said Motyl. “Mortality salience can increase people’s tendency to do good within their group, but it can potentially drive them to nasty behavior toward other groups. We’ve done a number of studies in many countries that found people who are feeling existential fears are more likely to support going to war with opposing nations.
“When people think about death, they are more punitive toward others who don’t share their beliefs. They’re also more cognitively rigid, less creative and more close-minded. So, while organ donation is a good thing, I’m a little concerned about the downstream effects of these reminders.”
Goldenberg is less worried about this. “I think we encounter subtle death reminders all the time,” she said.
“Death reminders are an inherent part of being alive,” agreed Pyszczynski. “Having said that, it’s certainly possible that these organ-donation appeals could enhance prejudice and close-mindedness, if that’s what gets activated. It depends on the individual, and what’s going on in their life at the moment.”
Such unhelpful reactions “tend to happen when a person feels their world view is under attack, belief system is being disrespected,” he noted. “The other side of it is, if you feel your values are secure—a feeling that could arise from affirming them on Facebook—you might be more likely to shift in a pro-social direction.”
“Facebook is a non-physical form of the self,” Goldenberg noted. “It distances people from their physical being.” That sort of distancing—along with the implicit promise that a record of who we are, and what we stand for, will live on after our death—makes the thought of our demise a little less scary, and the idea of organ donation a little more palatable.