Absence of significant dissent should be sufficient for deceased donor organ procurement in New Zealand
Article first published online: 6 OCT 2009
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
Australian and New Zealand Journal of Public Health
Volume 33, Issue 5, pages 449–454, October 2009
How to Cite
Douglas, T. M. and Douglas, N. M. (2009), Absence of significant dissent should be sufficient for deceased donor organ procurement in New Zealand. Australian and New Zealand Journal of Public Health, 33: 449–454. doi: 10.1111/j.1753-6405.2009.00427.x
- Issue published online: 6 OCT 2009
- Article first published online: 6 OCT 2009
- Submitted: August 2008 Revision requested: March 2009Accepted: June 2009
- organ donation;
- organ procurement;
- organ transplantation;
- informed consent;
- presumed consent;
- institutional ethics;
- New Zealand
Objective: New Zealand's organ donation rates are among the lowest in the OECD. In a bid to increase organ availability, the New Zealand Human Tissue Act 2008 introduces new consent arrangements for deceased donor organ procurement. This article assesses these new arrangements and presents the case for further reform.
Approach: Our assessment and arguments are based on philosophical analysis informed by empirical data on the effectiveness of alternative consent systems. We: 1) Identify widely held ethical judgments about policies and practices relevant to organ donation (e.g. those relating to coronial post-mortems), 2) Assess the implications of these judgments for the Human Tissue Act and the assumptions that underpin it, and 3) Derive policy recommendations that are consistent with the judgments.
Conclusion: The Human Tissue Act 2008 retains a strong consent requirement for organ procurement: organs may not be transplanted unless either the deceased or the family consents. We argue that organ availability could and should be increased by shifting from a model that requires consent to one that requires the absence of significant dissent.
Implications: We recommend that New Zealand adopt either 1) an organ donation system similar to the existing system for ordering coronial post-mortems, or 2) a variant of the ‘opt-out’ system already in place in several other countries.