Respecting wishes and avoiding conflict: understanding the ethical basis for organ donation and retrieval

Editor’s key points † The ethical aspects of consent to organ donation after death differ from those related to live donation or other situations. † Uncertainty about a potential donor’s wishes in life impedes successful donation. † There is often uncertainty over consent and the information required about procedures before or after death. † An alternative, more descriptive approach to donor consent is needed. Summary. Many people care deeply about what happens to their own and their loved ones ’ bodies after death. It is therefore important to capture individuals ’ wishes and ensure that they are respected as far as practically possible. At the same time, healthcare professionals need to feel confident that they are morally entitled to do what they need to do to ensure that someone’s wishes are fulfilled. This article explores the decision to donate one’s organs after death. It attempts to reconcile the way in which people are required to express their wish to donate organs with the need to reassure and support the professionals, who will care for them if they become potential donors. Current donor registration processes leave some professionals feeling that donors have not consented in the usual manner to procedures, which might be necessary before death. It is suggested that this issue could be addressed without imposing information overload on prospective donors, by changing the way in which the wish to donate is understood and expressed