The “Opt Out” Approach With Donor Registry
The “Opt Out” Approach With Donor Registry
Alicia M Piela
Salt Lake Community College
Introduction To Mortuary Science
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The “Opt Out” Approach With Donor Registry
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The “Opt Out” Approach With Donor Registry
Except for my visits to the DMV, organ donationi is not something I think about that often.
Luckily, I've never needed an organ and neither has anyone close to me. In my research I’ve
found some shocking facts and areas in the Donor Registry and current laws that in my opinion
need to be revisited and possibly changed. I believe that an "opt-out" system would better serve
America's needs. This system would automatically assume individuals wanted to donate their
organs, unless they earlier declared that they did not. The opt-out system is based on presumed
consent unless specified otherwise.
A recent survey (FitSugar, 2010) showed 95 percent of Americans support organ donation
however only 40 percent are registered organ donorsii. There have been several new proposals to
Congress that request an Opt Out Registry. This will allow all American Citizens, if medically
able, to be a Register Organ Donor with an opportunity to “Opt Out” if not interested in doing so,
for whatever personal reason.
Under the law of the United Statesiii, the regulation of organ donation is left to statesiv within the
limitations of the Uniform Determination of Death Actv, the National Organ Transplant Act of
1984vi, and the United Network for Organ Sharingvii. Each state's Uniform Anatomical Gift
Actviii seeks to streamline the process and standardize the rules among the various states. Many
states have sought to encourage the donations to be made by allowing the consent to be noted on
The “Opt Out” Approach With Donor Registry
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the driver's licenseix. Donor registries allow
for a central information center for an
individual's wish to be a donor. It is a pure
consent system rather than an opt-out
system.
Now in 2006 the law has been re-written
validating the Organ Donor Registry as a legally binding contract.
“Think back to when you first got your driver's license. You were asked whether you wanted to be an organ donor and
if the answer was 'yes,' all you had to do was check a box and sign your name. Until 2006, the decision to be an organ
donor was not legally binding, meaning that in the event that you died, family consent was required to fulfill your
wishes of being an organ donor even if you had checked that box and signed your name.
In 2006, a new law went into effect under Secretary of State Jesse White's task force on donor authorization: the FirstPerson Consent Law. Under this law, a person's indication to be an organ and tissue donor is now a legally binding
decision, one that does not require family permission or consent under any circumstances.
This law ensures that a person's wish to be an organ donor can no longer be revoked/overridden by family members
who may or may not be in the best state of mind to make important decisions such as to not let a loved one donate their
organs. More importantly, it was estimated that many more lives would be saved this way.
But for those of you who initially registered as an organ donor when you first got your driver's license, or anytime
before 2006, then you are not legally bound to be an organ donor. Because the law changed in 2006, people are now
required to register online if they want to be an organ and tissue donor. Those who already indicated that on their
licenses, but who have not registered online, are still organ donors, but their decision can be overridden by a family
member…" (Patel, 2010)
Recently there has been a proposal to the Organ Donor Registry in regards to obtaining a
Driver’s License called “Lauren's Law” (S3885-2011, 2011), which was passed through Senate
unanimously and has proposed a mandatory response of Organ Donor acceptance or declination
at the time of issuance. This would legally capture the majority of US Citizens, 18 years or
The “Opt Out” Approach With Donor Registry
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older,and place them in an Organ Donor Registry that is Nation Wide. This is not converting the
current program to an Opt-Out program but it certainly moves us in the right direction.
Even more promising than the Lauren Law, is a bill that was introduced to Colorado's
Legislature in January 2011, which would change the process for renewing driver licenses and
ID cards so applicants are assumed to be organ and tissue donors unless they initial a statement
that says they want to opt out.
In the U.S., however, similar approaches have been defeated by lawmakers in at least three states
— Delaware, Illinois and New York — because of concerns that donation programs seem
coercive if they require residents to say no.
Organ donation advocates hope for a warmer reception in Colorado, where nearly two-thirds of
people carrying driver's licenses or state-issued IDs volunteer as donors — a higher rate than in
any other state.
The Need Is Real
110,586 people are waiting for an organ
18 people will die each day waiting for an organ
1 organ donor can save up to 8 lives
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Last year alone, organ donors made more than 28,000 transplants possible. Another one million people
received cornea and other tissue transplants that helped them recover from trauma, bone damage, spinal
injuries, burns, hearing impairment and vision loss.
Every 11 minutes someone is added to the waiting list! Each day, about 77 people receive organ transplants.
However, 19 people die each day waiting for transplants that can't take place because of the shortage of
donated organs
(Registry, 2011)
What Can Be Donated? (Registry N. M., 2005)
Organ/TissueFunction
Who Will It Help
Heart
Pumps blood to all body
systems
Patients suffering from cardiomyopathy, coronary artery
disease or infants born with defective hearts.
Liver
Kidney
Energy regulation, makes
protein, removes waste
from blood
Filters waste from blood
Patients suffering from Wilson's disease, cirrhosis, other
life-threatening liver disease, or infants born with biliary
atresia.
Patients suffering from severe kidney failure caused by
conditions such as high blood pressure, diabetes, or
polycystic kidney disease. A transplant eliminates the need
for dialysis.
Lung
Organs of respiration
Patients suffering from emphysema, cystic fibrosis, or other
life-threatening lung diseases.
Pancreas
Makes enzymes needed Insulin dependent Type I diabetic patients. A transplant
for digestion, insulin
eliminates the need for insulin injections and reduces the
regulates blood sugars
risk of losing sight or limbs.
Intestine
Processes food ingested Patients suffering from short-gut syndrome and other lifethreatening intestine diseases.
Corneas
Allows light to enter the
eye
Skin
Protects body from
Patients with severe burns. Skin grafts provide a temporary
infection, dehydration and bandage to decrease pain, infection, scarring and
injury
dehydration.
Bone
Supports the body,
protects vital organs
Patients suffering from corneal blindness caused by
disease or injury.
Patients requiring facial reconstruction, limb salvage,
correction of birth defects, cancer treatment, oral surgery,
or spinal surgery.
Heart Valves Directs blood flow through Patients requiring replacement of a malfunctioning heart
the heart
valve. A donated valve is preferred over a mechanical or
pig valve.
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Tendons
Attaches muscles to bone Patients requiring reconstructive surgery commonly used in
the treatment of sports injuries.
Veins
Transports blood
Patients requiring coronary artery by-pass surgery. The
donated veins are used to replace the patient's blocked
arteries.
Conclusion
Currently there are 110,586 on a waiting list for an organ in the US. Clearly something needs to
be done. I suggest an opt-out system. This is not a new concept; it has already been adapted in
several other countries with great success. The "Opt-Out" system is common in Europe and is
credited with dramatically raising donation rates. In those European countries including France,
Belgium, Denmark, Finland, Italy, Sweden, Norway and Spain, there is an ‘opt-out’ system
where individuals are presumed to have consented to have their organs used for transplant unless
they specifically object.
This may have a significant impact on the total pool of potential donors – in Belgium, for
example, only 3%-4% opt out of donation. The British Medical Association has indicated its
support for an “opt-out” system of presumed consent.
The number of donors in the USA has declined following an initial increase on the introduction
of the "required request" rule. The key point about Spain is that, despite the fact that it routinely
consults relatives, it operates an opt-out system on behalf of the wishes of the donor. The only
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way of ensuring the maximization of donated organs is to operate a strict opt-out system so that
every suitable organ can be harvested and used for donation unless the donor specifically objects.
I believe in general it’s not the census of the population not to be a donor but rather just the mere
fact that currently it takes effort. Let’s face it, we’re a lazy society and if the Opt-Out system
went into effect, it would be the opposition of the few that would impact our availability of
organs.
I believe that all of us want to make a difference during our lives but think even further and make
a difference after.
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References
1.
FitSugar (01/20/2010). “Are You an Organ Donor?”, Jupiter Images, http://www.fitsugar.com/OrganDonation-United-States-7102926
2.
Darshan Patel, (April 10th, 2009) The Daily Illini Editorial Board,
http://www.dailyillini.com/opinions/editorials/2009/04/10/register-to-be-an-organ-and-tissue-donor-help-save-alife?q=opinions/editorials/2009/04/10/register-to-be-an-organ-and-tissue-donor-help-save-a-life
3.
Legislative Bill – Lauren’s Law, (April 13, 2011), http://open.nysenate.gov/legislation/bill/S3885-2011
4.
Registry (National Organ Donor Registry), (April 17, 2011) http://www.organdonor.gov/
5.
New Mexico Donor Services, (2005), http://www.donatelifenm.org/whatcanbedonated.htm
External links
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YES! Utah – Organ Donor Registration for Utah
National Organ Donation
New Mexico Donor Services NMDS
i
Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to
a living recipient in need of a transplantation. Transplantable organs and tissues are removed in a surgical procedure
following a determination, based on the donor's medical and social history, of which are suitable for transplantation.
Such procedures are termed allotransplantations, to distinguish them from xenotransplantation, the transfer of animal
organs into human bodies.
Registered Organ Donor is to become a legally binding donor registered with your state organization, i.e. – Utah:
https://www.yesutah.org/register/.
ii
iii
The law of the United States consists of many levels[1] of codified and uncodified forms of law, of which the
most important is the United States Constitution, the foundation of the federal government of the United States. The
Constitution sets out the boundaries of federal law, which consists of constitutional acts of Congress, constitutional
treaties ratified by Congress, constitutional regulations promulgated by the executive branch, and case law
originating from the federal judiciary.
iv
A U.S. state (abbreviation of United States state) is any one of the 50 federated states of the United States of
America that share sovereignty with the federal government. Because of this shared sovereignty, an American is a
citizen both of the federal entity and of his or her state of domicile.[1] Four states use the official title of
commonwealth rather than state. State citizenship is flexible and no government approval is required to move
between states (with the exception of convicts on parole).
v
The Uniform Determination of Death Act (UDDA) is a draft state law that was approved for the United States in
1981 by the National Conference of Commissioners on Uniform State Laws, in cooperation with the American
Medical Association, the American Bar Association, and the President's Commission on Medical Ethics. The act has
since been adopted by most US states and is intended "to provide a comprehensive and medically sound basis for
determining death in all situations"
vi
The National Organ Transplant Act (1984 Pub.L. 98-507), approved October 19, 1984 and amended in 1988
and 1990, outlawed the sale of human organs and provided for the establishment of the Task Force on Organ
Transplantation; authorized the Department of Health and Human Services to make grants for the planning,
The “Opt Out” Approach With Donor Registry
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establishment, and initial operation of qualified Organ Procurement Organizations (OPOs); and established the
formation of the Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients.
vii
United Network for Organ Sharing (UNOS) is a non-profit, scientific and educational organization that
administers the only Organ Procurement and Transplantation Network (OPTN) in the United States, established (42
U.S.C. § 274) by the U.S. Congress in 1984.
viii
The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the Uniform Acts drafted by
the National Conference of Commissioners on Uniform State Laws (NCCUSL) in the United States with the
intention of harmonizing state laws in force in the states.
Drivers License – In the United States, nearly all driver's licenses are issued by individual states (including
Washington, D.C. and territories), rather than the federal government. Drivers are normally required to obtain a
license from their state of residence, and all states recognize each other's licenses for temporary visitors subject to
normal age requirements. A state may also suspend an individual's driving privilege within its borders for traffic
violations. Many states share a common system of license classes, with some exceptions, and commercial license
classes are standardized by the federal law of 49 CFR part 383.[1][2]
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