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dc.contributor.authorGardiner, Dale C.
dc.date.accessioned2023-05-15T14:29:01Z
dc.date.available2023-05-15T14:29:01Z
dc.date.issued2017
dc.identifier.citationShaw, D., Georgieva, D., Haase, B., Gardiner, D.C., Lewis, P., Jansen, N., Wind, T., Samuel, U., McDonald, M. and Ploeg, R. (2017) 'Family over rules? An ethical analysis of allowing families to overrule donation intentions', Transplantation, 101(3), pp. 482-487. doi: 10.1097/TP.0000000000001536.en_US
dc.identifier.issn1534-6080
dc.identifier.urihttp://hdl.handle.net/20.500.12904/16992
dc.descriptionAvailable to read on publisher's website here: https://doi.org/10.1097/tp.0000000000001536.en_US
dc.description.abstractMillions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the "right" way and have recorded their wishes or live in a jurisdiction with a "presumed consent" system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed. In some jurisdictions, the rate of "family overrule" is over 10%. In this article, we provide a systematic ethical analysis of the family overrule of donation of solid organs by deceased patients, and examine arguments both in favor of and against allowing relatives to "veto" the potential donor's intentions. First, we provide a brief review of the different consent systems in various European countries, and the ramifications for family overrule. Next, we describe and discuss the arguments in favor of permitting donation intentions to be overruled, and then the arguments against doing so. The "pro" arguments are: overrule minimises family distress and staff stress; families need to cooperate for donation to take place; families might have evidence regarding refusal; and failure to permit overrules could weaken trust in the donation system. The "con" arguments are: overrule violates the patient's wishes; the family is too distressed and will regret the decision; overruling harms other patients; and regulations prohibit overrule. We conclude with a general discussion and recommendations for dealing with families who wish to overrule donation. Overall, overrule should only rarely be permitted.
dc.description.urihttps://doi.org/10.1097/tp.0000000000001536en_US
dc.language.isoenen_US
dc.subjectOrgan donationen_US
dc.subjectBioethical issues
dc.titleFamily over rules? An ethical analysis of allowing families to overrule donation intentionsen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionVoRen_US
rioxxterms.versionofrecord10.1097/TP.0000000000001536en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.dateFCD2023-05-15T14:29:01Z
refterms.versionFCDVoR
refterms.panelUnspecifieden_US
html.description.abstractMillions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the "right" way and have recorded their wishes or live in a jurisdiction with a "presumed consent" system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed. In some jurisdictions, the rate of "family overrule" is over 10%. In this article, we provide a systematic ethical analysis of the family overrule of donation of solid organs by deceased patients, and examine arguments both in favor of and against allowing relatives to "veto" the potential donor's intentions. First, we provide a brief review of the different consent systems in various European countries, and the ramifications for family overrule. Next, we describe and discuss the arguments in favor of permitting donation intentions to be overruled, and then the arguments against doing so. The "pro" arguments are: overrule minimises family distress and staff stress; families need to cooperate for donation to take place; families might have evidence regarding refusal; and failure to permit overrules could weaken trust in the donation system. The "con" arguments are: overrule violates the patient's wishes; the family is too distressed and will regret the decision; overruling harms other patients; and regulations prohibit overrule. We conclude with a general discussion and recommendations for dealing with families who wish to overrule donation. Overall, overrule should only rarely be permitted.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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