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The Nicholas Effect

Updated: Jan 29, 2021

By Dina Biscotti and Nicole Biggart

In 1994, a seven-year-old boy from California, Nicholas Green, was vacationing in Italy with his family. He was shot and killed during an automobile robbery in Calabria, in southern Italy. His parents agreed to donate his organs and corneas to seven Italians waiting for transplants. His parents spoke openly to the media about their decision. The dramatic increase in organ donation in Italy, a country with a historically low rate of organ donation, has been referred to as “the Nicholas Effect” (l’effeto Nicholas).

Nicholas’s parents did interviews all over the world including Venezuela, India, and Poland about their reasoning for donating Nicholas’s organs and encouraging more donations. They clearly had humanitarian reasons for their efforts.

As Reg Green, Nicholas’s father, wrote in a 2019 LA Times story:

"Saving lives is the most obvious result of any decision to donate. But there are less tangible benefits that testify to the strength of the human spirit. Organ donation leaps the barriers between us: The hearts of black women beat inside white women — and vice versa. Muslims are breathing through Jewish lungs — and vice versa. And, as I always like to remind audiences, some Republicans now see the world through Democratic corneas — and vice versa."

A television movie, “Nicholas’ Gift” starring Jaime Lee Curtis and Alan Bates, was based on the book that Reg Green wrote. Biannually since 2001, the World Transplant Games Federation has held the Nicholas Cup, a skiing competition reserved for children who have undergone a transplant.

The Nicholas Effect is a clear example of the social nature of exchange. The donation of organs – and not their sale – is an example of moral, communal, or associative reasoning. In fact, most countries have banned the sale of human organs believing a price logic is both inappropriate and subject to abuse of the healthy poor who might feel pressured to sell their organs. It is what Michael Walzer calls a “blocked exchange” in Spheres of Justice.

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