Which of the following is an argument against presumed consent?

• A. Damages trust between doctors and families of patients who are at the end of life.
• B. Leads to immediate universal adoption.
• C. There are no ethical concerns.
• D. It guarantees consent cannot be contested.

Answer: (A)

Presumed consent in organ donation assumes individuals are willing to donate unless they opt out, but the strongest worry is that it can erode trust between doctors and families at a vulnerable time. When a patient is at the end of life, families look to clinicians for guidance and respect for the patient’s wishes; if organs are procured under a presumption of consent, families may feel that their loved one’s autonomy and the family’s input were overridden, leading to distress, anger, and doubt about whether medical care was truly focused on the patient. This erosion of trust can have lasting consequences, including declining willingness to seek care or to engage with healthcare systems in the future. The other statements miss the ethical core: presumed consent does not automatically cause universal adoption, there are real ethical concerns to consider, and it does not guarantee that consent cannot be contested since families or surrogates can still object or override decisions in many systems.