Imagine a 28-year-old married woman with two children who is brain dead from a car accident. Without her written consent, authorization to donate her kidneys will be sought from:

• A. The oldest child
• B. Her husband
• C. The hospital ethics committee
• D. Her parents

Answer: (B)

When someone cannot consent and there’s no living will or registered consent, the responsibility for surrogate medical decisions falls to the closest appropriate family member, with the spouse commonly being the default surrogates for an adult. In this scenario, the husband is the person most likely to have the authority to authorize organ donation because he is the legally recognized surrogate decision maker for an adult spouse who is incapacitated and lacks an advance directive.

The oldest child or the parents are not the primary decision makers in this situation, especially when a spouse is still living, and the hospital ethics committee is there to guide and review decisions rather than to make the donation authorization itself. If there were a registered donor designation or a documented advance directive, that would guide the decision, but without those, the spouse is the one approached for consent.