First address informed consent in organ donation

doi:10.1136/bmj.39234.422361.3A

BMJ 2007;334:1179 (9 June), doi:10.1136/bmj.39234.422361.3A

Letters

Presumed consent

First address informed consent in organ donation

English's arguments in favour of presumed consent for organdonation ignore serious problems with the current system oforgan transplantation.¹ People who sign organ donation cardsclaiming that they will be donating organs "after my death"may not realise that organ donors declared dead by brain basedcriteria are not dead in the usual sense. Their hearts are beating,their bodies are warm, and they do not seem to be dead. Familymembers may be understandably reluctant to sign a form authorisingwhat they believe to be the killing of their loved one by removalof vital organs.

In addition, there has been widespread questioning of both thephilosophical and scientific viability of brain death criteria.²³ Such questioning of brain death criteria by reputable physiciansand philosophers should not be taken lightly and shows thatpresumed consent for a practice that may involve doctors killingpatients is premature.

Finally, before any notion of presumed consent can be considered,the issue of adequate informed consent to organ donation mustbe addressed. Without adequate informed consent, the currentsystem of voluntary consent for organ donation is problematic.Any system of presumed consent is also problematic.

Michael Potts, professor of philosophy

Methodist University, Fayettville, NC 28311-1498, USA

gratiaetnatura{at}yahoo.com

Competing interests: None declared.

References

English V. Is presumed consent the answer to organ shortages? Yes. BMJ 2007;334:1088. (26 May.)[Free Full Text]
Potts M, Byrne PA, Nilges RG, eds. Beyond brain death: the case against brain-based criteria for human death. Dordrecht: Kluwer, 2000.
De Mattei R, ed. Finis vitae: is brain death still life? Rome: Consiglio Nazionale delle Richerche, 2006.