Associate Professor David Ernest Intensive Care Specialist - Monash Health, Victoria, Australia, Adjunct Clinical Associate Professor - Monash University, Victoria, Australia.
J Law Med. 2023 Dec;30(4):899-906.
A current inconsistency in organ donation is the ability for a family to veto a valid consent for organ donation by a deceased individual; yet the family is unable to veto a valid refusal. Reasons proposed for accepting or rejecting family veto include concerns regarding distress (individual's family vs potential recipients), impact on organ donation rates, and regard for the deceased individual's autonomy. Advance care directives (ACDs) provide an ethical and legal framework for documenting medical treatment decisions which allow an individual to provide directives and to appoint a medical treatment decision-maker to act on their behalf. I argue that consent for organ donation as an ACD under the Medical Treatment Planning and Decisions Act 2016 (Vic) addresses the arguments in support of family veto. This may be an effective ethical and legal framework for managing family veto to meet the needs of the individual, family and community more effectively.
器官捐赠中存在一个矛盾之处，即家属有权否决已故者生前有效的器官捐赠同意书，但却无法否决有效的器官捐赠拒绝书。赞成或反对这种做法的理由包括对悲痛（个人的家属与潜在受赠者）、对器官捐赠率的影响以及对死者自主权的尊重等方面的担忧。预先护理指示（ACD）为记录医疗决定提供了一个伦理和法律框架，使个人能够提供指示，并指定一名医疗决策代理人代表其行事。我认为，根据 2016 年《维多利亚州医疗治疗规划和决策法案》将器官捐赠同意书作为 ACD 处理，可以解决支持家属否决权的论点。这可能是一个有效的伦理和法律框架，可以更有效地管理家属否决权，以满足个人、家庭和社区的需求。
