Opt-out, mandated choice, and informed consent
Opt-out, mandated choice, and informed consent
A number of authors criticise opt-out (or ‘deemed consent’) systems for failing to secure valid consent to organ donation. Further, several suggest that mandated choice offers a more ethical alternative. This article responds to criticisms that opt-out does not secure informed consent. If we assume current (low) levels of public awareness, then the explicit consent secured under mandated choice will not be informed either. Conversely, a mandated choice policy might be justifiable if accompanied by a significant public education campaign. However, if this entitles us to assume that members of the public are informed, then an opt-out system would also be justified in the same circumstances. The alleged advantages of mandated choice seem to rest on an unfair comparison, between mandated choice with a public education campaign and an opt-out system without one. While it may be that some countries with opt-out systems should do more to inform their publics, I see no reason to assume that this cannot be done. Indeed, advocates of mandated choice seem committed to thinking it possible to raise awareness. If opt-out systems adopt the same methods, such as writing to every individual, this should also address concerns about whether consent is informed.
consent, donation, mandated choice, opt-out, organs, presumed consent
862-868
Saunders, Ben
aed7ba9f-f519-4bbf-a554-db25b684037d
November 2023
Saunders, Ben
aed7ba9f-f519-4bbf-a554-db25b684037d
Saunders, Ben
(2023)
Opt-out, mandated choice, and informed consent.
Bioethics, 37 (9), .
(doi:10.1111/bioe.13228).
Abstract
A number of authors criticise opt-out (or ‘deemed consent’) systems for failing to secure valid consent to organ donation. Further, several suggest that mandated choice offers a more ethical alternative. This article responds to criticisms that opt-out does not secure informed consent. If we assume current (low) levels of public awareness, then the explicit consent secured under mandated choice will not be informed either. Conversely, a mandated choice policy might be justifiable if accompanied by a significant public education campaign. However, if this entitles us to assume that members of the public are informed, then an opt-out system would also be justified in the same circumstances. The alleged advantages of mandated choice seem to rest on an unfair comparison, between mandated choice with a public education campaign and an opt-out system without one. While it may be that some countries with opt-out systems should do more to inform their publics, I see no reason to assume that this cannot be done. Indeed, advocates of mandated choice seem committed to thinking it possible to raise awareness. If opt-out systems adopt the same methods, such as writing to every individual, this should also address concerns about whether consent is informed.
Text
Bioethics - 2023 - Saunders - Opt‐out mandated choice and informed consent
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More information
Accepted/In Press date: 20 September 2023
e-pub ahead of print date: 4 October 2023
Published date: November 2023
Additional Information:
Funding Information:
I thank my employer, the University of Southampton, for a period of research leave, during which this article was written and later revised. I am also grateful to two anonymous referees for their comments and suggestions.
Publisher Copyright:
© 2023 The Authors. Bioethics published by John Wiley & Sons Ltd.
Keywords:
consent, donation, mandated choice, opt-out, organs, presumed consent
Identifiers
Local EPrints ID: 483026
URI: http://eprints.soton.ac.uk/id/eprint/483026
ISSN: 0269-9702
PURE UUID: dfbadd42-db24-47f0-b661-59a0415dab93
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Date deposited: 19 Oct 2023 17:00
Last modified: 18 Mar 2024 03:30
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