Article Text

PDF
Normative consent and presumed consent for organ donation: a critique
  1. Michael Potts1,
  2. Joseph L Verheijde2,3,
  3. Mohamed Y Rady4,5,
  4. David W Evans6
  1. 1Methodist University, Fayetteville, North Carolina, USA
  2. 2Departments of Biomedical Ethics, Physical Medicine, and Rehabilitation, Mayo Clinic, Phoenix, Arizona, USA
  3. 3Center for Biology and Society, School of Life Sciences, Arizona State University, Tempe, Arizona, USA
  4. 4Department of Critical Care Medicine, Mayo Clinic, Phoenix, Arizona, USA
  5. 5Center for Biology and Society, School of Life Sciences, Arizona State University, Tempe, Arizona, USA
  6. 6Queens College, Cambridge, UK
  1. Correspondence to Professor Michael Potts, Methodist University, 5400 Ramsey Street, Fayetteville, NC 28311-1498, USA; gratiaetnatura{at}yahoo.com

Abstract

Ben Saunders claims that actual consent is not necessary for organ donation due to ‘normative consent’, a concept he borrows from David Estlund. Combining normative consent with Peter Singer's ‘greater moral evil principle’, Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. This paper disputes Saunders' arguments. First, if death caused by the absence of organ transplant is the operational premise, then, there is nothing of comparable moral precedence under which a person is not obligated to donate. Saunders' use of Singer's principle produces a duty to donate in almost all circumstances. However, this premise is based on a flawed interpretation of cause and effect between organ availability and death. Second, given growing moral and scientific agreement that the organ donors in heart-beating and non-heart-beating procurement protocols are not dead when their organs are surgically removed, it is not at all clear that people have a duty to consent to their lives being taken for their organs. Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of ‘mandatory consent’. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • The concise argument
    Søren Holm