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Ethics of Surrogate Consent for Living Organ Donation
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To the Editor: I would like to comment on some of the objections to surrogate allowance of organ donation in patients with persistent or permanent vegetative state (PVS) in the article by Drs Wendler and Emanuel.1 I believe that the authors’ concerns about donation occurring before legal determination of death and about the selective donation of only nonvital organs ignores the possibility that surrogates can be educated about how intrinsic value, prognostic uncertainty, and societal need surround decision making in the donation of organs.
I also believe that the 9 safeguards proposed by the authors for consent for living organ donation are not effective. Patients with PVS by definition are not brain dead and therefore are not usually apneic but breathe spontaneously, making this criterion difficult to apply. Neither specific signs (such as positive apnea test results or the withdrawal of medical treatment) nor involving a clinician can guarantee an . . . [Full Text of this Article]
Raquel M. Schears, MD
schears.rocky@mayo.edu
Department of Emergency Medicine
Mayo Clinic
Rochester, Minn
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