How Low Socioeconomic Status Hinders Organ Donation: An Extended Self Account

Abstract Past studies find that lower socioeconomic status (SES) individuals are less likely to donate organs. Building on the extended self literature, we propose that this effect occurs in part because the body is more central to the sense of self of lower-SES individuals. We test our predictions across seven studies (N = 8,782) conducted in different countries (United States and Brazil) with qualitative, observational, and experimental data in controlled and field settings. Results show that lower-SES individuals ascribe a greater weight to their bodies in forming their self-concept, which reduces their willingness to donate organs. Consistent with this rationale, socioeconomic disparities in organ donation are attenuated when (a) conceptions of selfhood prioritize non-physical aspects (e.g., the mind) over physical aspects (e.g., the body), and (b) appeals emphasize organ donation as a means to extend one’s sense of self (e.g., “let yourselves live through others”). Overall, this research documents an unexplored psychological barrier to organ donation and provides insights into how donation rates can be increased among lower-SES individuals.