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September 27, 1995

Mandated Choice for Organ Donation-Reply

Author Affiliations

The Genesee Hospital Rochester, NY

JAMA. 1995;274(12):942-943. doi:10.1001/jama.1995.03530120034029

In Reply.  —In his assessment of the potential impact of mandated choice, Dr Prottas misses several important points. First, although 60% of families may consent, families are not always asked to donate.1 Second, even if consent rates were similar, mandated choice would likely yield more organs than does our present system, since it would eliminate delays that can jeopardize the quality of organs. Third, because devoting thought to donation correlates with willingness to donate, mandated choice may induce undecided people to become donors, since it forces every adult to consider this issue. Finally, the suggestion that mandated choice might decrease the organ supply assumes that the ultimate authority would still rest with the family, when in fact it would not.Prottas' attack of the ethics of mandated choice is also ill conceived. While any mandate does limit autonomy, most would agree that society should establish rules designed to ensure

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