Which of the following statements is an ethical implication commonly associated with presumed consent?

• A. Increases the speed of emergency organ retrieval.
• B. Requires explicit confirmation from the donor's family in every case.
• C. Preserving patient autonomy is not affected.
• D. Raises mistrust in the healthcare system.

Answer: (D)

Presumed consent means people are treated as organ donors unless they opt out, so the ethical tension is between using a policy intended to save lives and protecting how much individuals’ preferences are respected. The most commonly discussed implication is that this approach can undermine trust in the healthcare system. If people perceive that their autonomy is being overridden by a default, or fear that families won’t have a say in decisions about their loved ones, they may view the system as coercive or opaque. That erosion of trust can reduce public willingness to engage with medical institutions or to participate in donation programs, which undermines the policy’s goals. To counter this, systems emphasize clear public education, easy opt-out processes, and sensitive handling of family input to maintain legitimacy.