The number of Canadians awaiting transplants continues to exceed the number of organs donated, so the growing concern over "family veto" should come as no surprise.1-3 The practice of respecting a family's objection to donation over the deceased's validly executed consent affects the availability of life-saving organs, disrespects donor autonomy and infringes existing Canadian legal norms. Yet many provincial/ territorial agencies and organ donation organizations indicate on their websites that families' wishes take priority over an individual's legally valid consent. Last year in Ontario, for example, 21% of families of registered donors refused donation.3 This situation is legally problematic and confusing for the public, patients and health care providers. It also highlights the need for donation and transplantation communities to be aware of, and adhere to, the law governing consent for donation. The legal authority to procure a deceased person's organs comes from valid consent for donation. Unlike consent for medical treatment, organ donation legislation does not impose a standard of "informed consent." A person's consent is legally valid if it meets the formal legislative requirements: generally, a document that is signed, dated and witnessed. Consent can be given by an individual before death or, in some circumstances, by next of kin4 (Appendix 1, available at www.cmaj.ca/lookup/suppl/doi: 10.1503/cmaj.160752/-/DC1). Next of kin have legal authority to consent or withhold consent on the individual's behalf only in situations where the individual has not already provided valid consent. This is true across Canada, although the Northwest Territories' legislation is somewhat unclear on this point. When an individual has already pro...

Evaluating the “family veto” of consent for organ donation

10.1503/cmaj.160752