Routine Inquiry About Organ Donation -- an Alternative to Presumed Consent
Veatch, Robert M.
New England Journal of Medicine. 1991 Oct 24; 325(17): 1246-1249.
As of April 1991, there were 22,842 people in the United States on the waiting lists for organs for transplantation. The list is getting longer each year. Many patients die waiting for organs. Others must be maintained on dialysis for want of a transplantable kidney. It is understandable that some people are growing impatient with the system of voluntary donation embodied in the Uniform Anatomical Gift Act -- a law that requires specific consent for donation and that has been in place now for two decades. The idea of presuming that the deceased person would consent to the use of his or her organs for lifesaving transplantation is now receiving renewed, more serious attention. Such a change in policy would require specific refusal rather than specific consent for the use of an organ. Although the sentiment favoring the change is understandable, there are good moral and practical reasons why presumed consent is an idea whose time has not come and why other approaches, including a truly systematic effort to ask about donation while patients are still alive and competent, are better, morally more defensible, and more effective. In order to see why, it is necessary to explore both the moral logic behind presumed consent and the alternatives available.
Advance Directives; Alternatives; Body Parts and Fluids; Cadavers; Consent; Donor Cards; Emergency Care; Family Members; Hospitals; Law; Moral Policy; Organ Donation; Patients; Policy Analysis; Presumed Consent; Property Rights; Public Opinion; Public Policy; Property; Required Request; Rights; Scarcity; Third Party Consent; Tissue Donation; Transplantation; Waiting Lists;
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Veatch, Robert M. (1991-10-24)
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