Sqad. I just dislike the exceptions to the rule response..It sounds fine to generalise in this way until its rephrased back to individuals...alos as you know I have a deep aversion to the "doctor is always right" scenario
I have no problem with "required request" or opt out and often it will be absolutely evident that the patient is dead...just not happy with compulsion or entirely trusting the doc's decision who in some respects will be looking at the person and thinking "heart okay, lungs yup, kidneys, yup, liver...maybe, corneas yup...and don't tell me they never do think like that because I will not believe you.
As things stand when a potential donor is identified i.e someone who would meet the criteria of brain death, the next of kin would be approached by the medical team including a transplant coordinator and formally asked for permission. This is regardless of whether a donor card or entry on the donor register is present (although it makes things easier) Regardless of the patients expressed wishes when alive they could be over- ridden by the family although it is likely an advance directive refusing donation would be accepted (a colleague always threatened to donate her husbands organs even though he didn't approve of transplantation)
when my sis was pronounced BD, my dad was asked to make the decision, i take some comfort that other people have been able to live (hopefully) though her death.
i'm on the register but like others i think it should be an "opt out" system