Journal of medical ethics
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Journal of medical ethics · Aug 2010
End-of-life decisions as bedside rationing. An ethical analysis of life support restrictions in an Indian neonatal unit.
Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? ⋯ Explicit priority processes in India for financing neonatal care are needed. If premature neonates are perceived as worth less than other patient groups, the reasons should be explored among a broad range of stakeholders.
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Journal of medical ethics · Aug 2010
CommentNormative consent and presumed consent for organ donation: a critique.
Ben Saunders claims that actual consent is not necessary for organ donation due to 'normative consent', a concept he borrows from David Estlund. Combining normative consent with Peter Singer's 'greater moral evil principle', Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. ⋯ Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of 'mandatory consent'. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society.