How sympathy and fear mediate the interplay between benefit and scarcity appeal organ donation messages

Background: Organ transplantation is the most effective medical procedure to save people who are suffering from terminal organ failure. However, shortages of transplantable organs remain a universal problem. Although more than 90% of the U.S. population supports the concept of organ donation, only 60% are registered donors. Method: A 2 (other-benefit appeal vs. self-benefit appeal) × 2 (nonscarcity vs. scarcity appeal) online experiment (N = 312) was conducted to examine how sympathy and fear mediate the interplay between benefit and scarcity appeal in organ donation messages. Results: Other-benefit appeal message generated more sympathy than self-benefit appeal message in organ donation. The nonscarcity condition generated more positive attitudes toward organ donation than the scarcity condition. Sympathy and fear, respectively, exerted a significant impact on attitude and organ donation intentions under the nonscarcity and scarcity conditions. Conclusion: The results revealed that both sympathy and fear are underlying mechanisms that can change people’s attitudes and intentions of organ donation through different routes. Sympathy motivates people through altruism to reduce others’ suffering, whereas fear motivates people through viewing organ donation behavior as a value to help themselves cope with the fear of death. Because organ donation can remind people of their own death, resource scarcity can exacerbate people’s self-related fear of death, which may motivate them to suppress organ donation-related thoughts, rather than use organ donation as a defensive mechanism to cope with fear of death.