Nudge it: II – Power of the opt-out default option

Think of a situation that you are automatically enrolled for organ donation when you obtain your vehicle license; however, you have the option to “opt-out”. This is a classic “opt-out” default option. Here, you are being nudged for organ donation.

Its counterpart option is “opt-in”. In that situation, the default is that you are not in the program; you have to ask for it to enter into the organ donation program.

“The opt-out default option makes life easy.”

This seemingly simple change in the “choice architecture” has made a huge impact on behavior change without any cost for its implementation.

The “opt-out” default option has become the most powerful tool in the nudging toolbox: E.A.S.T./


a road crossing nudge with white strips

Nudging for behavior change – I: Use the E.A.S.T. tool


Look at the following figure;

The organ donation rates vary hugely by country due to the differences in this “choice architecture”; the organ donation rates are usually lower in countries that practice “opt-in” policy and extremely higher in countries that practice “opt-out” policy.

We practice the “opt-out” default option daily. For example, we pay our monthly bills through a bank account (we could call it “auto-enrollment with payroll reduction”. We do not have to think about it anymore as long as our salary goes to the same account. Another common example is the automatic loan repayment monthly through our bank accounts.

Think of another example. How about serving healthy foods to children as the “opt-out” default option in restaurants or in the school canteen? Of course, they can have other foods if they want.

This “opt-out” default option is the most effective nudge strategy. In 2019, Jachimowicz et al. published findings of a meta-analysis of 58 default studies published to that date. They found,

  • This opt-out default option make a huge influence on behavior (d=0.68; 95% confidence interval = -0.53 – 0.83)
  • Majority of studies showed positive effects on behavior.
  • The defaults on consumers events are more effective than on enviriomental events.
  • The default options are more effective when those options are seen by the users as enorsements by the “choice architect (designer), easyness of doing it than the alternate, and when they believe the option is the status quo (enorment).

Need more evidence-based examples? Here they are;

Subject areaIntervention link
EconomySave more tomorrow (SMART) retirement savings program Thaler and Benartz (2004)
HealthcareReducing the opioid prescription by clinicians in emergency departmentsDelgado et al (2018)
Healthcare Improving generic prescription by cliniciansPatel et al (2014)
Healthcarepreventing deaths by setting lower tidal volume in ventilatorsAcute Respiratory Distress Syndrome Network (2000)
Healthcarereferrals for cardiac rehab after a heart attackPatel et al (2018)
Environment automatic enrollment for renewal (green) energy sourcesPitchert et al. (2008); Kaiser et al. (2020)
Food making healthier food items as the default option in restaurantsWisdom et al. (2010); Peters et al. (2016)

What heuristics and cognitive biases the “opt-out” default option deals with?

Heuristic/ cognitive biasDescription How it works
Procrastination and InertiaWe prefer putting off taking action although they want to do it, particularly when the process is perceived as complex. We do not take action now because of fear or anxiety of doing that, or over-optimistic of having more time in the future, or thinking of making better-informed decisions (“best is the enemy of good”). Once enrolled, we tend to stay with it because it takes effort to move out of it.
status quo biasWe prefer to stay with what is doing although our inaction brings in a better or worse outcome. The opt-out default becomes the status-quo; no action is required.
Present biasWe prioritize today over tomorrow. We put more weight on today’s costs and benefits than future ones. We like immediate gratification.make the healthier one readily available as the default option so that extra effort does not require.
Loss aversion we put more weight on losses than gains and as a result, we are reluctant to move away from the status quo. Loss aversion discourages moving away from it after the automatic enrollment.

Problems and limitations of the opt-out default option

The “opt-out” option is not without its own criticisms and limitations. Yan and Yates (2019) provide a very good account of these problems in their article on attitudes towards opt-in and opt-out options.

The main criticism is whether it limits the freedom of choice and is manipulative. It is debatable particularly when it comes to sensitive topics such as organ donation.

The “Opt-out” default option may not work and become counterproductive in some instances. Consider the following situations;

  • The “opt-out” option does not require us to take active decisions becuase it is the default. One might think that is the standard or that is the most correct; in fact it is but may not for all.
  • It may not be suitable for instances that we might need continuued involvement such as ,,,
  • The implementers might drop to provide adequate education to perform a well-informed decision. As a result, the users satisfaction may diminish with time and more importantly the commitment.

A checklist for choice architects who want to design “opt-out” default option

The Behavioral Scientist has published a checklist based on their research for those who are interested in designing interventions using the “opt-out” default option. It includes the following strategic theme areas;

  • Endorsement
  • Ease
  • Endowment
  • Intensity and destribution of preferences

Author: Prasantha De Silva

A specialist in Community Medicine board-certified in Sri Lanka and a research analyst in Canada

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