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“Thank God for Facebook,” the liver transplant surgeon Andrew Cameron said earlier this week at a conference about behavioral economics and social media at Harvard Law School. Cameron directs transplants at Johns Hopkins Hospital in Baltimore and he was celebrating Facebook’s efforts–which a spokeswoman told me will soon intensify on the mobile site–to promote organ donation through new functionality and prompts shown to its users.  

Last May Facebook started letting users add organ-donation status to their Facebook “timelines,” telling friends and family of their status, and directing people who aren’t signed up to the official organ donor registries. Facebook’s effort garnered enormous publicity, and the United States experienced a real-world organ-registration surge. California, which normally gets 70 registrations a day with Donate Life California, saw about 2,000 the day after Facebook’s announcement (see “What Facebook Knows”). The effort is expanding around the world, too.

One reality check is warranted: the registration surge was largely if not entirely caused by extensive press coverage, not social pressure within Facebook. Within a few days after the May press frenzy, registrations fell back to levels at or near the old ones.  Facebook and research partners are working on getting data from states to do a fine-grained analysis to tease out a cause-and-effect relationships of the online nudges alone. It’s likely they’ll find one: to date, about 500,000 Facebook users have noted their status as organ donors on the site, according to Facebook spokesperson Sarah Feinberg.

But the project also raises an ethical conundrum. Once a global social platform wades into social engineering, who decides what desrves such efforts in the future? “I’m not focusing on Facebook in particular,” Jonathan Zittrain, a professor at Harvard Law School, remarked at the event. When a site with more than a billion active users can influence what those users do, it means they are “in a position to make choices which we thought were peer-to-peer,” he said. “We absolutely have to think about a framework about how to account for that.”

The effects could be dramatic. When Facebook ventured into another civic endeavor—encouraging people to vote on Election Day in 2010—it found, after tracking state records on who actually voted and carefully matching identities, that the effort boosted actual turnout by at least 340,000 votes (see “How Facebook Drove Voters to the Polls”) and possibly many more. In particular, it was the voting-reminder messages that included faces of friends that prodded the real-world voting. 

Facebook takes pains to describe it’s efforts as neutral. But let’s face it: any get-out-the vote effect on Facebook will tend to benefit Democrats, because Facebook usage skews younger and more tech-savvy. Zittrain posed the uncomfortable hypothetical: “Maybe if you ‘like’ Mitt Romney, among other things, I won’t encourage you to vote today?” (To be clear, this did not happen – at one point I had “liked” Mitt Romney as part of my reporting – and I still got the voting message.)

At the conference, Eliot Schrage, vice president for communications and public policy at Facebook, said the company feels “this tension between neutrality and intervention. The organ donation is an example of intervention.” He added: “Who should be the intervenors? We are not sure we should be the intervenors. The role of our platform is so people can leverage our platform in ways they think is valuable.” 

Once Facebook’s mobile organ-registraton effort ramps up in a few months it’s likely that evidence of a powerful positive results will emerge. We may start to see stories and photographs of people who are alive because someone else was nudged to register on Facebook. The pressure for Facebook to do more will increase. And everybody will understand how much power such platforms really have.

Thank God for Facebook, indeed. But also, Facebook is playing God. How will such engineering play out five, ten, or fifty years from now? All we can say for sure right now, is how easy it will be to do.

Meanwhile, here’s a link where you can register to donate your organs in the United States. Fifteen people die each day for lack of them. 

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Tagged: Computing, Communications, Mobile

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