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Organ Donation, Brain Death and the Family: Valid Informed Consent

Published online by Cambridge University Press:  01 January 2021

Extract

In July 2013, parents in Ohio objected to their 21-year-old son becoming an organ donor. Elijah Smith was involved in an accident and pronounced dead using neurological criteria. The organ procurement organization (OPO) went to court and argued that because the young man was brain dead and because his driver's license indicated that he wished to be a donor, the court should allow them to use his organs. The mother argued that her son did not understand what he was signing when he signed his license and that his signature did not reflect an informed decision. The court disagreed with her, saying that he had indicated a wish to donate his organs and that no one but Elijah could revoke that wish. His organs were removed.

Elijah's mother suspected that he did not understand what he was signing. She might have been right, given what we know about the process for obtaining permission for organ donation and the limited public understanding of brain death.

Type
Independent
Copyright
Copyright © American Society of Law, Medicine and Ethics 2015

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References

The Uniform Anatomical Gift Act stipulates that a person's decision to donate as communicated on a driver's license or through a donor registry can be revoked only by the person and not by his or her family (see National Conference of Commissioners on Uniform State Laws, UAGA, 2006, section 8). Families may not refuse to donate the organs of a decedent who had agreed to be a donor by signing a driver's license or registering in a state donor registry. The National Conference of Commissioners of Uniform State Laws, which drafted the UAGA, explained that “Section 8 is designed to state firmly the rule that a donor's autonomous decision regarding the making of an anatomical gift is to be honored and implemented and is not subject to change by others. Section 8 not only continues the policy of making lifetime donations irrevocable but also is restated to take away from families the power, right, or authority to consent to, amend, or revoke donations made by donors during their lifetimes.” See Anatomical Gift Act (2006), available at <http://www.uniformlaws.org/Act.aspx?title=Anatomical%20Gift%20Act%20%282006%29> (last visited April 27, 2015). NATCO, a professional organization for transplant professionals, published a position statement supporting the position that families should not be allowed to refuse donation when a person had signed a driver's license or was listed in a registry (First Person Consent, 2009, available at <www.natco1.org/Advocacy/files/First%20Person%20Consent.pdf> (last visited April 27, 2015)). While at one time OPOs hesitated or refused to violate a family's wishes, there has been a significant shift in the force of statements and policies advocating for taking this role away from the family. (last visited April 27, 2015). NATCO, a professional organization for transplant professionals, published a position statement supporting the position that families should not be allowed to refuse donation when a person had signed a driver's license or was listed in a registry (First Person Consent, 2009, available at (last visited April 27, 2015)). While at one time OPOs hesitated or refused to violate a family's wishes, there has been a significant shift in the force of statements and policies advocating for taking this role away from the family.' href=https://scholar.google.com/scholar?q=The+Uniform+Anatomical+Gift+Act+stipulates+that+a+person's+decision+to+donate+as+communicated+on+a+driver's+license+or+through+a+donor+registry+can+be+revoked+only+by+the+person+and+not+by+his+or+her+family+(see+National+Conference+of+Commissioners+on+Uniform+State+Laws,+UAGA,+2006,+section+8).+Families+may+not+refuse+to+donate+the+organs+of+a+decedent+who+had+agreed+to+be+a+donor+by+signing+a+driver's+license+or+registering+in+a+state+donor+registry.+The+National+Conference+of+Commissioners+of+Uniform+State+Laws,+which+drafted+the+UAGA,+explained+that+“Section+8+is+designed+to+state+firmly+the+rule+that+a+donor's+autonomous+decision+regarding+the+making+of+an+anatomical+gift+is+to+be+honored+and+implemented+and+is+not+subject+to+change+by+others.+Section+8+not+only+continues+the+policy+of+making+lifetime+donations+irrevocable+but+also+is+restated+to+take+away+from+families+the+power,+right,+or+authority+to+consent+to,+amend,+or+revoke+donations+made+by+donors+during+their+lifetimes.”+See+Anatomical+Gift+Act+(2006),+available+at++(last+visited+April+27,+2015).+NATCO,+a+professional+organization+for+transplant+professionals,+published+a+position+statement+supporting+the+position+that+families+should+not+be+allowed+to+refuse+donation+when+a+person+had+signed+a+driver's+license+or+was+listed+in+a+registry+(First+Person+Consent,+2009,+available+at++(last+visited+April+27,+2015)).+While+at+one+time+OPOs+hesitated+or+refused+to+violate+a+family's+wishes,+there+has+been+a+significant+shift+in+the+force+of+statements+and+policies+advocating+for+taking+this+role+away+from+the+family.>Google Scholar
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