Family override of valid donor consent to postmortem donation: issues in law and practice

Transplant Proc. 2008 Jun;40(5):1255-63. doi: 10.1016/j.transproceed.2008.03.159.


In 2005, 3974 Canadians were on waiting lists for organ transplants and 275 patients died while waiting. Canada's organ shortage has led to calls for changes to Canada's organ donation system and its legal framework. Herein we examine an issue in which law reform could both increase the number of available organs and better align practice with respect for autonomy, a core value underpinning the Canadian legal system: the issue of family overrides of a valid donor consent to postmortem donation. That is, we examine what should happen when an individual consented to postmortem donation but the family would like to override that consent. First, we examine the requirements for valid donor consent. Second, we consider the legal status of family overrides of valid donor consent in relation to postmortem donation. Third, we describe the available data with regard to the practice of permitting families to override valid donor consent and discuss the possible reasons for this practice. Finally, we describe and defend the desired results with respect to law reform and describe the actions needed to realize these results.

MeSH terms

  • Adult
  • Canada
  • Death*
  • Family* / psychology
  • Female
  • Humans
  • Informed Consent / legislation & jurisprudence*
  • Male
  • Presumed Consent / legislation & jurisprudence
  • Refusal to Participate*
  • Tissue Donors / legislation & jurisprudence*
  • Tissue Donors / supply & distribution