ABSTRACT
Autonomous expressions of will regarding the posthumous disposition of one's organs are most often not made while alive, and therefore a decedent's autonomous judgments are rarely known with certainty. A great change in the national system of organ procurement, a change grounded in the moral foundation of human autonomy, is now called for. Current American practice tacitly assumes that, absent specific notification to the contrary, decedents are best protected if people act as though they had autonomously willed that their organs not be donated for transplantation. The enlargement of organ supply required to meet these compelling needs does not appear feasible within the current framework of express consent, whether that consent be sought voluntarily or the request for consent be required by law. For utilitarian moralists, therefore, the justifiability of the proposed reform is plain. The majority of people now heartily support the concept of organ donation.
