This article tackles the current deficit in the supply of cadaveric organs by addressing the family veto in organ donation. The authors believe that the family veto matters-ethically as well as practically-and that policies that completely disregard the views of the family in this decision are likely to be counterproductive. Instead, this paper proposes to engage directly with the most important reasons why families often object to the removal of the organs of a loved one who has signed up to the donor registry-notably a failure to understand fully and deliberate on the information and a reluctance to deal with this sort of decision at an emotionally distressing time. To accommodate these concerns it is proposed to separate radically the process of information, deliberation and agreement about the harvesting of a potential donor's organs from the event of death and bereavement through a scheme of advance commitment. This paper briefly sets out the proposal and discusses in some detail its design as well as what is believed to be the main advantages compared with the leading alternatives.
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Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant's 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals' perspectives on deemed consent, drawn from interview data with 24 healthcare professionals in an NHS Trust in England, prior to the introduction of the legislation.
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This paper examines the Multistakeholder initiative (MSI) "German Initiative on Sustainable Cocoa (GISCO)". MSIs represent arenas in which heterogeneous actors from governments, businesses and civil society come together to achieve sustainability goals that they cannot achieve otherwise. The self-defined goals of GISCO are first, to improve the living conditions of cocoa farmers and their families; second, to conserve and protect natural resources and biodiversity; and third, to increase the share of sustainably produced cocoa.
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