The gift-of-life and family authority: A family-based consent approach to organ donation and procurement in China

China is developing an ethical and sustainable organ donation and procurement system based on voluntary citizen donation. The gift-of-life metaphor has begun to dominate public discussion and education about organ donation. However, ethical and legal problems remain concerning this "gift-of-life"discourse: In what sense are donated organs a "gift-of-life"? What constitutes the ultimate worth of such a gift? On whose authority should organs as a "giftof- life"be donated? There are no universal answers to these questions; instead, responses must be compatible with local cultural values. This paper argues that from a Confucian point of view, organs should be viewed as a gift from the donor's family, and that final dispositional authority should also rest with the donor's family. The worth of such a "gift"rests on the virtue of ren, the origin of which is family love. Ultimately, I will argue that a familybased consent model for deceased organ donation is not merely justified, but morally required in the Chinese cultural context.