Families should not be allowed to veto dead relatives' organ donation wishes

August 7, 2012

It has recently been suggested that patients should be kept alive using elective ventilation to facilitate the harvesting of organs for donation. But David Shaw, Honorary Lecturer at the University of Aberdeen believes there is a much simpler way to increase the number of donated organs – by ensuring that doctors respect the wishes of the deceased and over-rule any veto.

Veto by the is the main impediment to an increase in organ donation, with at least 10% of families refusing to donate. Yet Shaw points out that families have no legal grounds for over-riding the dead person's wishes if that person clearly wanted to donate - for example, by carrying an organ donor card - and they often come to regret their decision.

He suggests that clinicians who heed the veto "are complicit in a family denying its loved one's last chance to affect the world."

Giving in to the family, he says, "is unprofessional and lets down the patient and potential recipients of the ' organs elsewhere." Furthermore, the patient's organs have gone to waste, and several people have died as a result.

The family cannot be blamed for refusing to allow donation under such stress, and most doctors are reluctant to add to a family's suffering, he writes. However, he argues that doctors "are professionals with obligations to respect the wishes of the dead patient and to promote the health of the public."

Shaw urges clinicians in this position to conduct a thought experiment. As well as the family that is there in front of them, he says "they should also imagine confronting the families of those who will die as a consequence of not receiving the donor's organs."

Although we should treat the family compassionately, doctors do not have the same duty to the family as to dying patients or other patients who need organs, he adds.

He concludes: "To respect a family's veto when the patient was on the organ donor register is a failure of moral imagination that leads to a violation of the dead person's wishes and causes the death of several people (and all the sorrow consequent to this), and many family members who stop donation come to regret their decision. Moving towards elective ventilation might alienate would-be donors and will not be necessary if remember that respecting a veto of is unethical, unprofessional, and against the spirit of the law."

Explore further: Presumed consent not answer to solving organ shortage in US, researchers say

More information: www.bmj.com/cgi/doi/10.1136/bmj.e5275

Related Stories

Presumed consent not answer to solving organ shortage in US, researchers say

November 29, 2011
Removing organs for transplant unless person explicitly opts out of donation before death not best way to address scarcity, raises sticky ethical questions.

Intensive care nurses have doubts about method for establishing brain death

June 28, 2011
More than half of Sweden's intensive care nurses doubt that a clinical neurological examination can establish that a patient is brain dead. Intensive care nurses also perceive that this uncertainty can affect relatives when ...

Improving family consent in organ donation could save lives

December 22, 2011
Research published today in the British Journal of Anaesthesia suggests that organ donation rates in the UK could be increased if the current issues affecting declined consent are improved. At present, only 30% of the UK ...

Timing is crucial for family consent in brain dead organ donors

October 7, 2011
Hearts used in transplants can only be sourced from donors that are brain dead before circulation to their heart has ceased. Data from a study published in BioMed Central's open access journal Critical Care indicate that ...

Recommended for you

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

Best of Last Year – The top Medical Xpress articles of 2016

December 23, 2016
(Medical Xpress)—It was a big year for research involving overall health issues, starting with a team led by researchers at the UNC School of Medicine and the National Institutes of Health who unearthed more evidence that ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.