Response

Editor – Rady and Verheijde suggest that, uncorrected, NICE guidance could result in the violation of the religious values and human rights of potential donors and surviving families. We disagree with this interpretation. Our position, in summary, is that preserving life in order to determine the patient's best interests with regard to organ donation can be in the best interests of the patient. Where a patient's best interests can be determined without any delay (for example when their wishes are already known) no such delay would be in the best interests of the patient. We agree that the religious views of the patient regarding organ donation are an important component of their best interests. Where these religious views are unknown, stabilising the patient may provide the time necessary to determine and so respect such views. The procedures used to procure donated organs are a matter for a valid, but separate, debate and are not considered in our paper. The Ahsan case referred to by Rady and Verheijde considered the interrelationship between first the need to act in a patient's best interests and second the requirement that a proposed course of action must be reasonable for the court to conclude that the proposed course was an appropriate basis for the assessment of damages in a clinical negligence claim. That question arose in the specific context of a damages claim and does not arise in the context of the NICE guidance or our paper.