Abstract
Laws mandating that individuals wear a seat belt have the presumed goal of reducing motor vehicle accident fatalities, but the prevailing view is that they may reduce the number of organs available. I provide a conceptual model identifying mechanisms whereby the law could either increase or decrease organ donation. Exploiting variation across states and time in the adoption of primary seat belt enforcement, I investigate these mechanisms and estimate the effect of the law on the supply of organs. The law increases seat belt usage and decreases motor vehicle accident fatalities, which translates to a sizeable reduction in the number of motor vehicle accident‐based organ donors. In contrast, the law is not associated with changes in the number of organ donors from nonmotor vehicle accident‐based sources and is robust to controlling for hospital‐specific effects. The effects are concentrated within organs expected to be most negatively impacted by the seat belt. Although primary enforcement represents a net‐gain to society in terms of lives saved, the negative impact on organ donation suggests further emphasis be placed on policies aimed at increasing the availability of organs.
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