Colloquium: A Promise-Acceptance Model of Organ Donation
April 8, 2014
Ought we always to honor the wishes of the dead to donate their organs? If so, why? Is it ever ethically permissible to allow a family veto to override an individual’s express wish to donate? Ethical and legal theorists have proposed various models to answer such questions. I argue that a Consent Model, though natural, does not accord with the best understanding of donor autonomy. I then assess a Gift Model and a Promise Model, arguing that both fail to capture important data about the ability to revoke one’s organ donor status. Instead, I outline a novel alternative approach: a Promise Acceptance Model, under which becoming an organ donor is construed as accepting a promise that the state makes to you to use your medically suitable organs for transplant after you die. I argue that this model, which implies that family vetoes are impermissible, is compatible with current practice and captures the data the other models struggle to accommodate.