It is immoral to require consent for cadaver organ donation

Emson, H. E.

doi:10.1136/jme.29.3.125

Cited by 35 publications

(17 citation statements)

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“…Advocates of mandated donation system, a system based on the notion of normative consent (it is immoral for an individual to refuse consent) [38], and the belief that the body should be considered as “on loan” to the individual from the biomass [39], argue that people should not be permitted a choice in this matter. It is counter argued that choosing not to save someone’s life is not the same as murder, and that although utilitarianism makes no distinction between causing an event and allowing it to happen when it was physically within our power to prevent [40], people (and deontologist) differentiate between intended harm and foreseen harm [21].…”

Section: Discussionmentioning

confidence: 99%

Consenting options for posthumous organ donation: presumed consent and incentivesare not favored

et al. 2012

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BackgroundPosthumous organ procurement is hindered by the consenting process. Several consenting systems have been proposed. There is limited information on public relative attitudes towards various consenting systems, especially in Middle Eastern/Islamic countries.MethodsWe surveyed 698 Saudi Adults attending outpatient clinics at a tertiary care hospital. Preference and perception of norm regarding consenting options for posthumous organ donation were explored. Participants ranked (1, most agreeable) the following, randomly-presented, options from 1 to 11: no-organ-donation, presumed consent, informed consent by donor-only, informed consent by donor-or-surrogate, and mandatory choice; the last three options ± medical or financial incentive.ResultsMean(SD) age was 32(9) year, 27% were males, 50% were patients’ companions, 60% had ≥ college education, and 20% and 32%, respectively, knew an organ donor or recipient. Mandated choice was among the top three choices for preference of 54% of respondents, with an overall median[25%,75%] ranking score of 3[2,6], and was preferred over donor-or-surrogate informed consent (4[2,7], p < 0.001), donor-only informed consent (5[3,7], p < 0.001), and presumed consent (7[3,10], p < 0.001). The addition of a financial or medical incentive, respectively, reduced ranking of mandated choice to 7[4,9], p < 0.001, and 5[3,8], p < 0.001; for donor-or-surrogate informed consent to 7[5,9], p < 0.001, and 5[3,7], p = 0.004; and for donor-only informed consent to 8[6,10], p < 0.001, and 5[3,7], p = 0.56. Distribution of ranking score of perception of norm and preference were similar except for no-organ donation (11[7,11] vs. 11[6,11], respectively, p = 0.002). Compared to females, males more perceived donor-or-surrogate informed consent as the norm (3[1,6] vs. 5[3,7], p < 0.001), more preferred mandated choice with financial incentive option (6[3,8] vs. 8[4,9], p < 0.001), and less preferred mandated choice with medical incentive option (7[4,9] vs. 5[2,7], p < 0.001). There was no association between consenting options ranking scores and age, health status, education level, or knowing an organ donor or recipient.ConclusionsWe conclude that: 1) most respondents were in favor of posthumous organ donation, 2) mandated choice system was the most preferred and presumed consent system was the least preferred, 3) there was no difference between preference and perception of norm in consenting systems ranking, and 4) financial (especially in females) and medical (especially in males) incentives reduced preference.

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Section: Discussionmentioning

confidence: 99%

Consenting options for posthumous organ donation: presumed consent and incentivesare not favored

et al. 2012

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“…Ethical/philosophical issues relevant to postmortem organ donation include: 1) choosing among the various consenting systems 12,27 including, mandated "donation," 18,19 mandated choice, 4,28 explicit consent by donor and/or their family, 21 and presumed consent with a spectrum of enforcement and family involvement. [29][30][31][32] Lay people opinion regarding the consenting systems is crucial and expected to be culture and religion-specific; 7,8,12,27,31,33 2) offering financial and/or medical incentives that may increase donation rates 1,9,10 but are potentially connected to commercial trade; 23,26,27 3) whether people own their bodies the way they own their property and thus have similar rights to non-interference, donation, and selling 13,34 or that body ownership represents a legal relation between the owner and non-owners (rather than between the owner and the owned) and does not have to be a simple binary issue; 14,18,19 4) the legitimacy and weight of critical interests (as opposed to experiential interests) that living people may have when they cease to exist. 11,35 Does one's critical interest in the disposition of their organs trump the experiential interests of their family members and/or organ recipients?…”

Section: Introductionmentioning

confidence: 99%

<p>Modeling Lay People’s Ethical Attitudes to Organ Donation: A Q-Methodology Study</p>

Hammami¹,

Aboushaar²

2020

PPA

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Background: Organ donation is commonly evaluated by biomedical ethicists based largely on principlism with autonomy at the top of the "moral mountain." Lay people may differ in the way they invoke and balance the various ethical interests. We explored lay people's ethical attitudes to organ donation. Methods: Respondents (n=196) ranked 42 opinion-statements on organ donation according to a 9-category symmetrical distribution. Statements' scores were analyzed by averaginganalysis and Q-methodology. Results: Respondents' mean (SD) age was 34.5 (10.6) years, 53% were women, 69% Muslims (30% Christians), 29% Saudis (26% Filipinos), and 38% healthcare-related. The most-agreeable statements were "Acceptable if benefit to recipient large," "Explicit donor consent and family approval for live donation," "Acceptable if directed to family member," and "Explicit donor consent and family approval for postmortem donation." The most-disagreeable statements were "Donor consent and family approval not required for postmortem donation," "Acceptable with purely materialistic motivation," and "Only donor no-known objection for postmortem donation." Women, Christians, and healthcare respondents gave higher rank to "Explicit donor consent and family approval for live donation," "Only donor family consent required for postmortem donation," and "Acceptable if organ distribution equitable," respectively, and Muslims gave more weight to donor/family harm (p ≤0.001). Q-methodology identified various ethical resolution models that were associated with religious affiliation and included relatively "motives-concerned," "family-benefit-concerned," "familism-oriented," and "religious or nonreligious altruism-concerned" models. Of 23 neutral statements on averaging-analysis, 48% and 65% received extreme ranks in ≥1 women and men Q-methodology models, respectively. Conclusion: 1) On average, recipient benefit, requirement of both explicit donor consent and family approval, donor-recipient relationship, and motives were predominant considerations; 2) ranking of some statements was associated with respondents' demographics; 3) Q-methodology identified various ethical resolution models that were partially masked by averaging-analysis; and 4) strong virtue and familism approaches in our respondents provide some empirical evidence against principlism adequacy.

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“…Third parties may have a DER similar to the one that I will discuss in this paper, but third party duties raise difficult questions regarding the status of organs upon death. In particular, I wish to avoid debates over whether human cadavers should be considered a form of property (Truog, 2005) or whether this classification is inappropriate (Giordano, 2005;Emson, 2003). Instead, I will only focus on the narrower case of duties to arrange for transplantation of one's own organs after the one's death.…”

Section: Notesmentioning

confidence: 96%

Easy Rescues and Organ Transplantation

Snyder

2009

HEC Forum

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It is immoral to require consent for cadaver organ donation

Cited by 35 publications

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Consenting options for posthumous organ donation: presumed consent and incentivesare not favored

Consenting options for posthumous organ donation: presumed consent and incentivesare not favored

<p>Modeling Lay People’s Ethical Attitudes to Organ Donation: A Q-Methodology Study</p>

Easy Rescues and Organ Transplantation

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