Advance Commitment: An Alternative Approach to the Family Veto Problem in Organ Procurement

Jurgen De Wispelaere, Trinity College Dublin
Lindsay Stirton, University of Manchester

Abstract

In this article we propose to tackle the current deficit in the supply of cadaveric organs by addressing the family veto in organ donation. We believe that the family veto matters – ethically as well as practically – and that policies aimed at removing a genuine say of the family in this decision are likely to be counter-productive. Instead we propose to directly engage with the reasons why most families seem to object to the harvesting of a loved-one's organs who has signed up to the donor registry, notably a failure to fully understand and deliberate on the information and a reluctance to deal with this sort of decision at an emotionally distressing time. To accommodate these concerns we propose to radically separate the process of information, deliberation and agreement about the harvesting of a potential donor's organs from the event of death and bereavement through a scheme of advance commitment. This paper briefly sets out our proposal and discusses in some detail its design as well as what we believe to be the main advantages compared to the leading alternatives.