The Role of Relatives in Decision Making on Organ Donation– an Ethical Analysis

Abstract: Introduction: The three ways of making a wish for organ donation known are donor registration, donation card and telling the relatives. The relatives always have to be consulted to know the last expressed wish. If the wish was unknown there is a presumed consent, but the relatives have veto and can refuse organ donation. A new proposal suggests that the veto should be removed.Aim: To identify and analyse the ethical considerations concerning decision making on organ donation with an emphasis on the role of relatives.Methods: A search for literature was made. Scientific articles, debate articles, constitutional texts, reports and other texts were selected. The selection of sources was performed on the basis of relevance for the aim of the study which means for answering the research questions.Results: Recurrent themes were identified in studies with an emphasis on the experiences of relatives who have been part of decision making on organ donation. The themes identified were: “incompetence to decide”, “disagreement”, “lack of information and support”, “comprehension of brain death” and “protection”. The themes, together with the reading of debate articles and other texts, formed the basis of arguments in favour of and against relatives’ right to veto.Conclusions: There are many factors influencing relatives in their decision concerning organ donation. There are strong arguments against the relatives’ right to veto. Donor registration and a sensitive approach in the conversation with relatives are important factors to increase the consent rate and fulfil the wish of the deceased.