A surrogate or substitute decision maker is involved in medical decisions when an individual is incompetent to make his or her medical decisions. The question of who will serve as the surrogate and will decide on the behalf of an incompetent individual is ethical dilemmas which oblige court to reach at decisions. A big legal-ethical dilemma arises when the organ of an incompetent is sought to be for transplantation which must be explored under legal and ethical domains and should identify and appoint the authorities who take neutral decisions on their behalf.
This paper is based on a clinical scenario of an incompetent individual who was selected for organ donation as a result of his family decision.In Surgical Intensive Care Unit of a private hospital, I was assigned with a liver donor patient. Post operatively, patient was on ventilator, and when it was planned to off the sedations and wean off the patient from ventilator, I observed that patient was not obeying my commands.