Similar to the issues of the Baby Theresa case, the main ethical issue of presumed consent are whether one can assume consent in another (autonomy). Those who advocate for an opt-in system (the current system in the United States), say that it is unethical to assume a person would have consented if they did not explicitly state that wish. However, I propose that it is ethical as in the Presumed consent system (also called an opt-out system), one can, as the name implies, opt to not donate. This allows, just as the opt-in, a person to decide whether or not they wish to donate, but those who do not want to go to the effort of registering do not have to. This maximizes benefits as more people will donate. In the context of Baby Theresa, this system would assume she consented as she had to reason not to, therefore, the only ethical issue would be to allow her to die by not keeping her on a respirator.