Shaw David, Lewis Penney, Jansen Nichon, Samuel Undine, Wind Tineke, Georgieva Denie, Haase Bernadette, Ploeg Rutger, Gardiner Dale
Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
CAPHRI Research Institute, Maastricht University, Maastricht, the Netherlands.
J Intensive Care Soc. 2020 May;21(2):179-182. doi: 10.1177/1751143719846416. Epub 2019 May 7.
It is well known that families frequently overrule the wishes of dying patients who had previously expressed a wish to donate their organs. Various strategies have been suggested to reduce the frequency of these 'family overrules'. However, the possibility of families overruling a patient's registered decision not to donate has not been discussed in the medical literature, although it is legally possible in some countries. In this article, we provide an ethical analysis of family overrule of a relative's refusal to donate, using the different jurisdictions of the UK, Switzerland, Germany and the Netherlands to provide some context. Despite some asymmetries between overruling consent and overruling refusal, there are some cases in which donation should proceed despite a recorded refusal to do so.
众所周知，家属常常会否决那些此前已表达过器官捐献意愿的濒死患者的愿望。人们提出了各种策略来减少此类“家属否决”的发生频率。然而，尽管在一些国家从法律上来说家属有可能否决患者登记的不捐献决定，但医学文献中尚未对此进行过讨论。在本文中，我们利用英国、瑞士、德国和荷兰的不同司法管辖区情况，对家属否决亲属拒绝捐献的行为进行伦理分析。尽管在否决同意和否决拒绝之间存在一些不对称情况，但在某些案例中，即便有记录表明亲属拒绝捐献，器官捐献仍应继续进行。
