The Ethical Issue in Healthcare

Topic: Medical Ethics
Words: 1014 Pages: 4

Lack of organ donation is a significant problem in the United States that influence mortality. Thousands of Americans die each year while waiting for an organ transplant that could have saved their lives. At the same time, many people who could donate their organs after their death do not become donors due to the healthcare system’s formalities. For this reason, the ethical issue that will be addressed in this paper is the implementation of the policy of presumed consent to donation and the prohibition of family veto.

The presumed consent policy is a controversial issue because of people’s attitudes towards death and deceased people’s bodies’ sanctity. Currently, the United States has an expressed consent policy, which means that a person can become a donor after death only if they have applied the documents and officially confirmed their desire. At the same time, the presumed consent policy means that if a person does not formally declare their refusal to donate, their organs can be used after death. Thus, while part of the population believes that a deceased person’s organs should be used to benefit other people, another part considers the removal of organs without a person’s explicit consent to be disrespectful (Prabhu, 2019). However, this policy does imply that the family of the deceased can veto donation. In other words, the deceased’s family may prohibit the use of their organs even if the patient has not expressed a desire to donate, and many countries use this right. This issue is also controversial because although the family can make decisions in some cases, contradicting the person’s presumed desire is unethical.

Proponents of the policy and prohibition of family veto put forward several arguments. First, placing responsibility on a family experiencing the grief of the death can be traumatic and affect the decision’s adequacy (Prabhu, 2019). The family is faced with doubts and moral choices, especially if the donation issue has not been discussed, and they are forced to decide whether to leave the body intact or to benefit other people. In addition, the family may feel excessive sentimentality or shock due to grief and make decisions contrary to the will of the deceased consciously because of these feelings and pain.

Secondly, if a person did not refuse donation during their lifetime, they likely did it on purpose. Hence, a family veto can disrupt the deceased’s desire to benefit others. Third, studies show that a family’s right to veto is often used due to such disputes as religion or belief and significantly reduces the number of available donor organs (Costa-Font et al., 2021). In other words, if, for example, parents and children have different beliefs and attitudes towards donation, parents, after the death of a child, can be true to their beliefs and prohibit the use of organs. Such a right is unethical in relation to the deceased and people who could benefit from the donation. Therefore, the family’s lack of confidence in the deceased’s desires or unwillingness to fulfill their will is unethical for a potential donor and people who need transplantation.

At the same time, opponents of such a policy note that it is unethical. First, some people believe that presumed consent removes the value of the donation as a “gift” and diminishes its merit, which is especially important for religious people (Prabhu, 2019). However, this argument can be challenged by representatives of different religions or even different readings and understandings of the same issue. Secondly, in cases where the family knows about the deceased’s desire not to be a donor, they did not leave confirmation, and the relatives cannot influence the situation. This event is stressful for the family and is unethical for its members and the deceased. However, this issue can be circumvented in some countries’ policies if the family provides evidence (Shaw, 2017). Third, as long as information on the policy is not sufficiently distributed, people will unknowingly agree to donate (Prabhu, 2019). In other words, if people do not know that they can and should refuse a donation, if they oppose it, then the state figuratively steals their organs. Consequently, supposed consent is not real consent, according to this logic.

These arguments demonstrate that presumed consent and the prohibition of family veto raise many ethical questions for potential donors, their families, and people in need of transplantation. These concerns address issues of faith, the burden of choice and the family’s right to intervene, and the ability to increase access to organs and tissues for transplantation. However, I believe that it is beneficial for the health care system, since it increases the number of organs for transplantation and saves many lives. Today, an American needs to apply to become a donor, which can make it difficult for many people to take this step. Thus, presumed consent makes this process easier for everyone.

Nevertheless, the argument for the benefit of an extensive information company is appropriate and necessary, since each person should be aware that donation is a deliberate choice for them. This approach can be implemented as well as an informed consent policy. In other words, patients will be asked at a routine clinic visit if they know the policy and if they are willing to refuse the donation. Thus, the issue of family doubts and veto power will cease to be an ethical health problem.

In conclusion, although the issue of presumed content to donation and the prohibition of family veto is an ethical issue, many disputes can be resolved. For example, the adoption of a policy that allows the veto under certain circumstances, as well as a national information campaign, will eliminate the debate about awareness of a person’s choice. Although religion and faith issues will remain relevant for many people, it will only force them to take timely measures to refuse the donation. In addition, most often, religious canons and traditions depend on their reading, so the opportunity to give another person a chance to live can be considered a good deed. In this way, the problem of shortage of organs for transplantation will decrease and benefit many people.


Costa-Font, J., Rudisill, C. & Salcher-Konrad, M. (2021). ‘Relative Consent’ or ‘Presumed Consent’? Organ donation attitudes and behaviour. The European Journal of Health Economics, 22, 5–16. Web.

Prabhu, P. K. (2019). Is presumed consent an ethically acceptable way of obtaining organs for transplant? Journal of the Intensive Care Society, 20(2), 92–97. Web.

Shaw, D. (2017). Presumed consent to organ donation and the family overrule. Journal of the Intensive Care Society, 18(2), 96–97. Web.

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