Which statement about presumed consent best captures an ethical concern?

• A. Increasing organ availability without any cost.
• B. Respecting patient autonomy is always fully preserved.
• C. Public trust is guaranteed under presumed consent.
• D. Potential erosion of trust in healthcare institutions.

Answer: (D)

The main concept being tested is how presumed consent can affect trust in the medical system and respect for autonomy. Presumed consent aims to increase organ donation by assuming assent unless someone opts out, but this can raise ethical concerns because people may feel their autonomy is not truly respected and that medical decisions could be driven by procurement goals rather than patient welfare. If the public perceives that consent is being assumed without clear, ongoing opportunities to express individual preferences, trust in healthcare institutions can erode. This erosion can reduce willingness to seek care, participate in medical programs, or support organ donation in the future, undermining the policy’s aims.

The other statements don’t capture this ethical tension as precisely. Presumed consent does not guarantee organ availability at no cost, as implementing opt-out systems involves resources and logistics. It also does not guarantee that autonomy is fully preserved for everyone, since some individuals may not opt out or may be unaware of their rights. And it certainly does not guarantee public trust; in fact, it can undermine trust if people feel their rights are overridden.