Table 2.
Role of next-of-kin in presumed consent nations
| Nation | Next-of-kin informed | Next-of-kin’s authorization required if wishes are unknowna | Next-of-kin can veto donation |
| Armenia | Yes | n/a | Yes |
| Austria | Yesb | n/a | Yesb |
| Belarus | Yes | n/a | Yesc |
| Belgium | Yes | Nod | Noe |
| Chile | Yes | n/a | Yesf |
| Colombia | Yes | Yesg | Yes |
| Costa Rica | Yes | Yesg | Yes |
| Croatia | Yes | Yes | Yes |
| Czech Republic | Yes | n/a | Yes |
| Ecuador | Yes | Yes | Yes |
| Finland | Yes | Yes | Noe |
| France | Yes | Noh | Yes |
| Italy | Yes | Yes | Yes |
| Luxembourg | Yes | Yes | Yes |
| Norway | Yes | Yes | Yes |
| Paraguay | Yes | Yes | Yes |
| Poland | Yes | Noh | Yes |
| Russia | Yesb | Yesb | Yesb |
| Singapore | Yes | Yes | Noe |
| Slovak Republic | Yes | n/a | Yes |
| Slovenia | Yes | Yes | Yesi |
| Spain | Yes | Yes | Yes |
| Sweden | Yes | Noj | Noe |
| Tunisia | Yes | Yes | Yes |
| Turkey | Yes | Yes | Yes |
‘Wishes Unknown’ refers to nations that provide a method for individuals to express a desire to be a donor in addition to a method to objecting to deceased donation. Nations that do not provide such a means are marked not applicable (n/a).
Next-of-kin must be present in the hospital at the time of donation for their opinion to be considered.
The transplant co-ordinator has the discretion to choose if the next-of-kin’s permission is necessary. In addition, there is an authorized law agent in attendance during procurement.
The next-of-kin are informed of the intended procurement but permission is not explicitly asked. An objection will be respected.
If the deceased expressed their wish to donate, then only they can revoke the decision and upon death their decision will be respected and next-of-kin will not be able to revoke it.
Legally, the next-of-kin’s permission is not required if no objection is made, but if there are doubts, the next-of-kin are consulted.
Presumed consent is only practiced if the next-of-kin are unreachable or unknown.
When the deceased’s wishes are unknown, the next-of-kin is asked what the deceased’s opinion on organ donation was. However, if the next-of-kin objects to donation the removal will not occur.
In rare cases where the next-of-kin raises an objection against donation the physician can decide not to proceed with removal, if he/she feels continuing would have a major negative impact on the next-of-kin.
If next-of-kin do not object, procurement will proceed under the presumption of consent. However, next-of-kin have a legal right to object and must be informed of this right. If they cannot be reached, donation may not occur.