Special Section: Consent and Organ Donation Reflections on the Nature of Public Ethics

This article explores the differences between the activities of ethical deliberation in the academy and in the public domain, in particular in the work of bodies appointed to advise government. It draws attention to the collegiate nature of their work, the constraints imposed by their constitution, and the need to incorporate attention to the sociopolitical context. It argues that such ‘‘public ethics’’ is fundamentally a contingent process, driven by pragmatic arguments rooted in particular times and places. If this is correct, the work of advisory bodies should be assessed on a different basis from academic papers and should be regarded more as historical documents than works of principle. The nature of the ‘‘expertise’’ that should be brought to bear and some related questions about the concept of evidence-based policymaking are also considered. When asked, in 2008, to advise on the introduction of a system of presumed consent or an opt-out system, the UK Organ Donation Taskforce (ODT), a multidisciplinary group charged with improving donation rates, concluded that such a system should not be introduced at that time. The main reasons given were as follows: