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The side effects of deemed consent: changing defaults in organ donation
  1. David M Shaw1,2
  1. 1 Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
  2. 2 Department of Health, Ethics and Society, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
  1. Correspondence to Dr David M Shaw, Institute for Biomedical Ethics, Universität Basel, Basel 4056, Switzerland;{at}


In this Current Controversy article, I describe and analyse the imminent move to a system of deemed consent for deceased organ donation in England and similar planned changes in Scotland, in light of evidence from Wales, where the system changed in 2015. Although the media has tended to focus on the potential benefits and ethical issues relating to the main change from an opt-in default to an opt-out one, other defaults will also change, while some will remain the same. Interaction of these other defaults with the principal one raise several ethical issues that may complicate efforts to use deemed consent to increase donation rates. Most significantly, changing the main default will have the effect of changing the default for patients' families, who play a vital role in the consent process.

  • vital organ donation
  • informed consent
  • donation/procurement of organs/tissues
  • transplantation

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  • Contributors DS is the sole author.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Patient consent for publication Not required.

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