Throughout the article, Saunders often discusses presumed consent. Presumed consent is the idea that we can assume that a person's organs can be used and that this allows us to take them as if they had consented to organ donation, unless they have registered an objection. This is challenging because it implies that consent is an attitude of mind – something like approval – rather than an act. Saunders argues that if consent must be given, then it cannot simply be presumed without any act having been performed