Symons Xavier, Poulden Billy
Plunkett Centre for Ethics, Australian Catholic University, Sydney, NSW Australia.
The University of Notre Dame Australia, Fremantle, Australia.
Asian Bioeth Rev. 2022 Apr 29;14(3):259-270. doi: 10.1007/s41649-022-00206-5. eCollection 2022 Jul.
Organ transplant shortages are ubiquitous in healthcare systems around the world. In response, several commentators have argued for the adoption of an opt-out policy for organ transplantation, whereby individuals would by default be registered as organ donors unless they informed authorities of their desire to opt-out. This may potentially lead to an increase in donation rates. An opt-out system, however, presumes consent even when it is evident that a significant minority are resistant to organ donation. In this article, we defend a mandated choice framework for consent to deceased organ donation. A mandated choice framework, coupled with good public education, would likely increase donation rates. More importantly, however, a mandated choice framework would respect the autonomous preferences of people who do not wish to donate. We focus in particular on the Australian healthcare context, and consider how a mandated choice system could function as an ethical means to increase the organ donation rate in Australia. We make the novel proposal that all individuals who vote at an Australian federal election be required to state their organ donation preferences when voting.
器官移植短缺在世界各地的医疗系统中普遍存在。对此，一些评论家主张采用器官移植的选择退出政策，即除非个人告知当局其选择退出的意愿，否则默认将其登记为器官捐赠者。这可能会导致捐赠率上升。然而，选择退出系统即使在明显有相当一部分人抵制器官捐赠的情况下也假定存在同意。在本文中，我们捍卫一种关于死后器官捐赠同意的强制选择框架。一个强制选择框架，再加上良好的公众教育，可能会提高捐赠率。然而，更重要的是，一个强制选择框架将尊重那些不想捐赠的人的自主偏好。我们特别关注澳大利亚的医疗环境，并考虑强制选择系统如何能够作为一种道德手段来提高澳大利亚的器官捐赠率。我们提出一个新颖的建议，即所有在澳大利亚联邦选举中投票的个人在投票时都必须表明其器官捐赠偏好。
