Abstract Some countries such as Australia, Spain, Norway, Italy and Canada allow next of kin to override the consent of registered organ donor candidates if they personally do not concur with the donation desire of their relative. This form
of surrogate decision‐making represents a double standard in terms of the principle of substituted judgment (the surrogate's duty). Further, double‐standard surrogate decision‐making in the setting of organ donation is a slippery slope to unethical surrogate decision‐making
while patients are alive. Concerns about family distress and donor candidate revocation of consent can still be managed without permitting double‐standard surrogate decision‐making.