Chouhan P, Draper H
Centre for Biomedical Ethics, Department of Primary Care and General Practice, The Medical School (Primary Care/T Building), University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
J Med Ethics. 2003 Jun;29(3):157-62. doi: 10.1136/jme.29.3.157.
Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation.
在关于奥尔德希医院及其他地方事件的报告发布后，在英国，推定器官捐赠同意似乎越来越不太可能成为增加器官获取量的一个可行选项。然而，鉴于增加可用尸体器官数量的替代方案要么是接受更多的活体捐赠，要么是接受人们将继续因器官短缺而死亡，公共政策制定者仍有义务考虑其他提高获取率的方法。在本文中，我们回应了对强制选择的主要反对意见（即它会破坏自主性且强制捐赠更可取）。我们对传统的强制选择方法进行了修改，以考虑到强制捐赠更可取这一反对意见的影响力，即承认人们在器官捐赠问题上能够且确实会做出糟糕的决定，并提议所有关于尸体捐赠的配套公共教育和信息都应倾向于支持捐赠。
