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This article proposes an ethical assessment of transplantation institutions with deceased donnors by the role they grant to the surviving family. Its aim is twofold. Firstly, it shows that legislations give the surviving family a significant power to determine posthumous removal, even though they are usually described as based on the concerned person’s consent. Secondly, the article shows that policies that give such a power to families fail to respect a duty of fairness, that is, to take into account the interests of both concerned persons before they die and diseased persons who are likely to die.