The Author’s Response

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I would like to thank professors Baines and Jindal for their response1 to our article.2 There are indeed several approaches to tackling the family overrule. As I have written elsewhere, techniques of ethical persuasion can be used to remove the biases that affect families in this situation.3 The UK Donation Ethics Committee has also provided detailed discussion of how to sensitively deal with families in these difficult situations.4
However, it appears improbable that the approach suggested by Profs Baines and Jindal would decrease the rate of family overrule of organ donation. Whatever the motivation for donation on the part of the patient, referring to the abstract philosophical concepts used by Immanuel Kant is not a good example of communication skills; it could alienate families, particularly if they are told they are not adhering to a “moral law.” Telling families that what they are doing is unethical is insensitive enough without adding unnecessary philosophical rhetoric. Relatives of potential organ donors are in a very challenging situation, and it is not surprising that they should sometimes act contrary to reason. The more sensitive approaches mentioned above represent more appropriate avenues to pursue in reducing the rate of family overrule.
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