Presumed consent
| Autor: | D. J Hill, T. C Palmer, D. W Evans, S. Cansdale, R. Cansdale |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
education.field_of_study
medicine.medical_specialty business.industry media_common.quotation_subject Population General Engineering General Medicine Deception Repeal Surgery Silence Informed consent Life support General Earth and Planetary Sciences Medicine Organ donation Obligation business education Intensive care medicine General Environmental Science media_common |
| Zdroj: | BMJ. 318:1490-1490 |
| ISSN: | 1468-5833 0959-8138 |
| DOI: | 10.1136/bmj.318.7196.1490 |
| Popis: | Editor—Beecham reports that the BMA wants to start a debate on presumed consent to organ donation.1 Ethically, consent should be informed, whether it is expressed or presumed. Presumed consent to organ donation takes for granted that everyone who has not registered an objection consents to their organs being taken for the benefit of others when they are brain stem dead and that they understand what this state is. It is not, however, death as ordinarily understood. Nor is it “brain death” as defined in various parts of the world. Its status is controversial, not least because claims that, for example, it invariably leads to death within a few hours or days are no longer tenable.2 Under our present system, willingness to donate organs is a positive offer. People who carry donor cards, and those on the NHS Organ Donor Register, have agreed to the removal of various organs “after my death” (the wording on the card) and may have no idea of the condition they will be in if the offer is taken up. They may never have given the matter serious consideration. People would probably have the greatest difficulty in obtaining the information that artificial ventilation and spontaneous heart beat and circulation will continue after they are pronounced brain stem dead while some brain and even brain stem activity persists. It remains a common misconception that all life support is withdrawn before surgery or organ harvesting begins. Further, it is not generally known that some anaesthetists give full anaesthesia for organ harvesting while others paralyse the patient but withhold anaesthesia. If consent is to be presumed there is a prior obligation to provide the population with all relevant information in readily accessible form. Failure to do so might risk charges of deception by silence and omission. Public suspicion of transplant practices seems to have been behind the recent repeal of a presumed consent law in Brazil.3 If a system of presumed consent is to be introduced it must ensure that those whose silence is taken to presume consent are fully aware of all the relevant facts. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|