A New York assemblyman has introduced a bill aimed at making the state the first to presume people want to donate their organs unless they specifically say otherwise. Under current law, people give permission to donate their organs by checking a box on their driver’s licenses or filling out a donor card.
The legislation, introduced by Assemblyman Richard Brodsky, a Westchester Democrat, is in two parts: the first step would end the right of the next of kin to challenge the decisions of their dead or dying relatives to donate their organs.
In a second measure, which is far more contentious, people would have to indicate in official documents — their driver’s licenses, most commonly — that they specifically don’t want to donate organs. If the box is not checked, it is presumed the person wants to donate.
What are the ethical and practical issues involved in changing the law? Is a “presumed consent” system an effective way to increase the number of organs available, and thus save lives, or will it deter public support for donation?
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If we're going to presume people are organ donors unless they opt out, there needs to be a reward for not opting out. Donated organs should be allocated first to those who haven't opted out. People who opt out of organ donation should go to the back of the transplant waiting list. The United Network for Organ Sharing, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required.
Americans who want to donate their organs to other registered organ donors don't have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.
According to a new survey by Donate Life America 43 percent of people are undecided, reluctant or do not wish to have their organs and tissue donated after their deaths. Is this because Americans don't know there is an organ shortage? No. The survey also reports that 78 percent realize there are more people who need organ transplants in the U.S. than the number of donated organs available.
Just about every single one of the 43% of Americans who aren't willing to register as organ donors would accept an organ transplant if they needed one to live. As long as we let non-donors jump to the front of the waiting list when they need transplants we'll always have an organ shortage.
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