John is a 30-year-old man suffering from severe mental handicap (IQ:30) and epilepsy, without other physical deformities or illness. He is sociable, would initiate social interaction (physical), enjoys a cuddle and going out on trips. He has no communication skills but is able to understand basic commands like ‘open your mouth’, ‘sit down’ and so on. He has been a long-term in-patient in a mental handicap hospital for the past 15 years. He is from an affluent family and had been admitted because of his family's inability to cope. He has visits from his mother once a month, and from his father less frequently. A few months ago his mother left a verbal instruction to the ward staff to make arrangements to donate his organs and to ask me, as responsible medical officer, to leave written instructions to inform the local Organ Transplant Team before his death, whenever it becomes imminent, so that the Organ Transplant Team can remove the necessary organs on his death.