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Marketing to register organ donors may circumvent principles of informed consent

BMJ 2012; 345 doi: (Published 31 August 2012) Cite this as: BMJ 2012;345:e5850
  1. Eleanor Milligan, associate professor in ethics and professional practice, School of Medicine, Griffith University, Southport, Gold Coast, Qld 4215, Australia,
  2. Sarah Winch, senior lecturer in health care ethics, School of Medicine, University of Queensland, Brisbane, Qld, Australia,
  3. Rebekah Adams, year 1 student, School of Medicine, University of Queensland
  1. Correspondence to: E Milligan e.milligan{at}

Organ donation and transplantation are seen as indisputable medical successes that are a communal moral good. Twin themes dominate the public debate: low organ supply is creating a preventable health tragedy, and increasing supply will solve the growing problem of organ failure. Health education and marketing campaigns to boost donation rates accompany the public debate, and they typically use emotive and persuasive language (“gifts of life”; “joy from tragedy”) to assert the worth of donation and transplantation. Ultimately, their aim is to secure advance consent from potential organ donors through registries.1

Current and prospective medical decision making relies on five well established criteria: competency; disclosure of material information; optional and voluntary participation; understanding the nature, risks, and benefits; and participation without coercion. Together these criteria form the doctrine of informed consent that lends ethical legitimacy to healthcare interventions through respecting patient autonomy.2 For posthumous organ donation, consent is sought from the dead person’s substitute decision maker at the time of organ harvesting. The donor registry indicates the wishes of the dead person and so provides a form of advance consent.

Increasing donor registrations through marketing campaigns …

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