Bond University School of Medicine, University Drive, Gold Coast, Queensland, Australia.
Intern Med J. 2013 Feb;43(2):120-3. doi: 10.1111/imj.12029.
Some countries such as Australia, Spain, Norway, Italy and Canada allow next of kin to override the consent of registered organ donor candidates if they personally do not concur with the donation desire of their relative. This form of surrogate decision-making represents a double standard in terms of the principle of substituted judgment (the surrogate's duty). Further, double-standard surrogate decision-making in the setting of organ donation is a slippery slope to unethical surrogate decision-making while patients are alive. Concerns about family distress and donor candidate revocation of consent can still be managed without permitting double-standard surrogate decision-making.
一些国家，如澳大利亚、西班牙、挪威、意大利和加拿大，如果近亲不同意其亲属的捐赠意愿，可以推翻注册器官捐献者候选人的同意。这种形式的代理决策在替代判断原则（代理人的职责）方面代表了双重标准。此外，器官捐赠背景下的双重标准代理决策是向患者存活时不道德的代理决策滑坡。即使不允许双重标准的代理决策，也可以处理家属的困境和捐献者候选人撤销同意的问题。
