Think of a situation where 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 behaviour 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./

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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)
• The majority of studies showed positive effects on behaviour.
• The defaults on consumer events are more effective than on environmental events.
• The default options are more effective when those options are seen by the users as endorsements by the “choice architect (designer), easiness of doing it than the alternate, and when they believe the option is the status quo (endorsement).

Need more evidence-based examples? Here they are;

Subject area	Intervention	link
Economy	Save more tomorrow (SMART) retirement savings program	Thaler and Benartz (2004)
Healthcare	Reducing the opioid prescription by clinicians in emergency departments	Delgado et al (2018)
Healthcare	Improving generic prescription by clinicians	Patel et al (2014)
Healthcare	preventing deaths by setting lower tidal volume in ventilators	Acute Respiratory Distress Syndrome Network (2000)
Healthcare	referrals for cardiac rehab after a heart attack	Patel et al (2018)
Environment	automatic enrollment for renewal (green) energy sources	Pitchert et al. (2008); Kaiser et al. (2020)
Food	making healthier food items as the default option in restaurants	Wisdom et al. (2010); Peters et al. (2016)

Relation between the heuristics and cognitive biases and the “opt-out” option

Heuristic/ cognitive bias	Description	How it works
Procrastination and Inertia	We 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, 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 bias	We prefer to stay with what we are doing although our inaction brings in a better or worse outcome.	The opt-out default becomes the status quo; no action is required.
Present bias	We prioritize today over tomorrow. We put more weight on today’s costs and benefits than on 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 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 because it is the default. One might think that is the standard or that is the most correct; in fact, it is but may not be for all.
• It may not be suitable for instances in which we might need continued involvement such as ,,,
• The implementers might drop to provide adequate education to perform a well-informed decision. As a result, the user’s satisfaction may diminish with time and more importantly the commitment.

A checklist for choice architects who want to design an “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 distribution of preferences