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In the Balance |

Mandated Choice for Organ Donation: Time To Give It a Try

Aaron Spital, MD
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From the University of Rochester School of Medicine, Rochester, New York. Acknowledgments: The author thanks Sam Spital for his very helpful suggestions. Requests for Reprints: Aaron Spital, MD, The Genesee Hospital, 224 Alexander Street, Rochester, NY 14607.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;125(1):66-69. doi:10.7326/0003-4819-125-1-199607010-00010
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A severe shortage of organs greatly limits the ability to deliver the miracle of transplantation to people suffering from end-stage organ disease. Contributing to this shortage is a high rate of refusal among families who are asked for permission to remove organs from a recently deceased relative. Mandated choice offers an alternative to obtaining consent from the family by returning control to the individual. This plan would require all adults to record their wishes about posthumous organ donation and would consider those wishes binding. By moving the decision-making process to a relaxed setting and ensuring that a person's wishes would be honored, mandated choice would hopefully take advantage of favorable public attitudes toward donation and thereby facilitate organ procurement. Preliminary research suggests that public commitment to organ donation would increase under mandated choice. A pilot study of this promising proposal should be undertaken.





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