Death and Deliberation: Respecting Family Preferences in Organ Procurement

What role (if any) should the family have in decision over organ donation? In practice the family is often provided with a de facto veto over the transplant decision. This means that donation is not carried out if the family objects. This raises several concerns, not least because family refusal rates account for significant amounts of organs not being utilized for transplant in spite of the wishes of the person who is the source of those organs. Most who uphold the view that we should keep the family veto in place do so for practical reasons, but there has been surprisingly little debate over the virtues of current practices. The ethical case against the family veto is connected to issues of autonomy and self-determination often considered important in the context of organ procurement. As many maintain that we should uphold the veto for practical reasons, the final section address practical issues and policies which could lessen the loss of life associated with upholding the current practice, while still giving some weight to the concerns and wishes of the family.