Thursday, June 14, 2007

Organ Donation in Pennsylvania

Several years ago, I promised Peter C. Wolk, Esq. -- a brilliant & patient man -- that I would try to arrange posting of his excellent article entitled "How Lawyers Can Assist Their Clients with Respect to Organ Donation" on the website of the Pennsylvania Bar Association.

Unfortunately, that never happened; but I post it now on this Blog to fulfill my promise.

His article was printed in the Winter, 2005 issue of the Newsletter of the PBA's Real Property, Probate & Trust Law Section. And forms of his article were posted on the websites of other bar associations, such as the Washington State Bar Association, through its Real Property, Probate & Trust Law Section, as indicated here:
We have posted a short article on How to Become an Organ and Tissue Donor in Washington that provides useful information for both attorneys and their clients. This article contains links to form donor cards, information on the types of tissue and organs that can be donated, and other sites on the internet that provide useful information on organ donations.

A second piece, How Lawyers Can Assist Their Clients with Respect to Organ Donation provides practitioners with three simple questions we can ask our clients to see if they would like to participate in an organ donation program.
At the time of our discussions, Peter had graduated cum laude from American University Law School, held a Masters Degree from Harvard University, and was a Phi Beta Kappa graduate of Trinity College (CT); and he had embarked on a lawyer education outreach project for the U.S. Division of Transplantation about organ donation.

Since then (according to a
presentation announcement dated September, 2006), it appears that Peter founded, and now serves as the Executive Director of, the National Center for Nonprofit Law, in Washington, D.C., and authored a book, The Art of Creating Nonprofit Organizations.

Organ donation remains an important topic for Pennsylvanians. Lawyers have a role in raising the topic with clients during discussions on personal & estate planning matters. And the public deserves simple answers to questions about organ donation.

So, I provide needed information, and I fulfill my promise (in a fashion), by posting his article here, updated by me with current links to resources. Its copyright remains in Mr. Wolk.

How Lawyers Can Assist Their Clients with Respect to Organ Donation

A major cause of the shortage of organs is that regardless of a decedent's wishes, virtually no surgeon will take organs or tissue without permission from the family. Regrettably, family members often withhold authorization because they are unaware the decedent wished to donate organs and tissues, thereby frustrating organ donors' wishes.

In fact, a national study conducted by Gallup indicates that when family members know of their loved one's wishes, 94% will honor the request. But, when family members do not know, only 54% will donate the relative's organs. Indeed, of all the causes for organs being unavailable from people who wanted to be donors, 37% are lost due to the family's refusal to consent. Those lost organs (from people who wanted to be organ donors!) could save many lives.

Attorneys are uniquely positioned to help by asking clients during estate planning and Will intake sessions if they want to be organ donors and if they have told their family. (Whether someone decides to be or not to be an organ donor is a personal decision that is respected; the purpose here is to ensure that people who want to make anatomical gifts do not have their wishes thwarted.) Sharing the decision to be an organ donor also has the effect of sparing surviving family members from the difficulty of having to make a burdensome, personal decision at an emotional time.

The American Bar Association supports more client education about organ donation issues:

RESOLVED, That the American Bar Association urges all attorneys to raise with their clients, when appropriate, the topic of organ and tissue donations and to provide donation forms to those clients who indicate an interest in making a donation.

See: Summary of Action of the House of Delegates, American Bar Association 1992 Mid-Year Meeting, Dallas, Texas, p. 30 (February 3-4, 1992). (Full text of the Resolutions and additional organ donor information is printed in the ABA pamphlet: "A Legacy for Life" (free on the ABA website; $12/100 pamphlets in print). [See: Reposting of this pamphlet on the ACTEC website here.]

As a lawyer, you can help by asking your clients the following questions during Will intake interviews:

1. Do you wish to be an organ and tissue donor?

Self -------> Yes ____ No ____

Spouse --> Yes ____ No ____

2. If yes, have you signed an organ donor card or indicated on your driver's license your intent to be an organ and tissue donor?

Self -------> Yes ____ No ____

Spouse --> Yes ____ No ____

3. Have you told your family about your intention to be an organ and tissue donor?

Self -------> Yes ____ No ____

Spouse --> Yes ____ No ____

What People Should Know About Organ and Tissue Donation in Pennsylvania

If you wish to be an organ and tissue donor, all you have to do is say yes to organ and tissue donation on your donor card and/or driver's license and discuss your decision with your family.

Nationally, about 63 people receive an organ transplant every day, but another 15 people on the waiting list die because not enough organs are available. In Pennsylvania alone, 478 people died [in 2003] waiting for an organ donation and 6,185 people are currently awaiting organ and tissue transplants.

One part of the problem is that some people who sign donation cards are not treated as donors.

Even if you've signed something, your family will likely be asked to give consent before donation can occur. Make sure that you talk to your family members about organ and tissue donation so they know your wishes!

One individual organ donor can save or improve the quality of life for more than 50 people who suffer from organ failure, congenital defects, bone cancer, orthopedic injuries, burns or blindness.

Who can become a donor?

All individuals can indicate their intent to donate (persons under 18 years of age must have parent's or guardian's consent). Medical suitability for donation is determined at the time of death. Are there age limits for donors?

There are no age limitations on who can donate. The deciding factor on whether a person can donate is the person’s physical condition, not the person’s age. Newborns as well as senior citizens have been organ donors. Persons under 18 years of age must have parent's or guardian's consent.

How do I express my wishes to become an organ and tissue donor?

  1. Indicate your intent to be an organ and tissue donor on your driver’s license.
  2. Carry an organ donor card.

If I sign a donor card or indicate my donation preferences on my driver’s license, will my wishes be carried out?

Even if you sign a donor card it is ESSENTIAL THAT YOUR FAMILY KNOWS your wishes. Your family may be asked to sign a consent form in order for your donation to occur.

If you wish to learn how organ donation preferences are documented and honored where you live, contact your local organ procurement organization (OPO). The OPO can advise you of specific local procedures, such as joining donor registries, that are available to residents in your area.

What can be donated?

  • Organs: heart, kidneys, pancreas, lungs, liver, and intestines
  • Tissue: cornea, skin, bone marrow, heart valves, and connective tissue
  • Bone marrow

If I sign a donor card, will it affect the quality of medical care I receive at the hospital?

No! Every effort is made to save your life before donation is considered.

Will donation disfigure my body? Can there be an open casket funeral?

Donation does not disfigure the body and does not interfere with having a funeral, including open casket services.

Why should minorities be particularly concerned about organ donation?

Some diseases of the kidney, heart, lung, pancreas and liver are found more frequently in racial and ethnic minority populations than in the general population. Successful transplantation often is enhanced by the matching of organs between members of the same ethnic and racial group.

Are there any costs to my family for donation?

The donor’s family does NOT pay for the cost of the organ donation. All costs related to donation of organs and tissues are paid by the recipient, usually through insurance, Medicare or Medicaid.

Can I sell my organs?

No! The National Organ Transplant Act (Public Law 98-507) makes it ILLEGAL to sell human organs and tissues. Violators are subject to fines and imprisonment. Among the reasons for this rule is the concern of Congress that buying and selling of organs might lead to inequitable access to donor organs with the wealthy having an unfair advantage.

How are organs distributed?

Patients are matched to organs based on a number of factors including blood and tissue typing, medical urgency, time on the waiting list, and geographical location.

How many people are currently waiting for each organ to become available so they can have a transplant?

Click here for the most current data -> United Network for Organ Sharing.

Can I be an organ and tissue donor and also donate my body to medical science?

Total body donation is an option, but not if you choose to be an organ and tissue donor.

If you wish to donate your entire body, you should directly contact the facility of your choice to make arrangements. Medical schools, research facilities and other agencies need to study bodies to gain greater understanding of disease mechanisms in humans. This research is vital to saving and improving lives.

Where can I get additional information about organ and tissue donation?
  • Statistics and additional information about organ and tissue donation are available at: United Network for Organ Sharing, and the Division of Transplantation, U.S. Department of Health and Human Services.
  • Information on minorities and organ donation and transplantation is available at the website of the Minority Organ Tissue Transplantation Education Program.
  • Information about the American Bar Association’s efforts with regard to organ donation, and the ABA pamphlet entitled “A Legacy for Life” may be found here.
  • Information about local Organ Procurement Organizations and local activities and facts about organ donation may be found at: Organ Procurement Organizations (Organ procurement organizations coordinate activities relating to organ procurement in a designated service area. They evaluate potential donors, discuss donation with family members, and arrange for the surgical removal of donated organs. OPOs also are responsible for preserving organs and arranging for their distribution according to national organ sharing policies. There are currently 59 organ procurement organizations throughout the U.S.). The Association of Organ Procurement Organizations (AOPO) is a private, nonprofit organization recognized as a national representative of organ procurement organizations.
  • Information about the Uniform Health- Care Decisions Act (UHCDA) (approved by the Uniform Law Commissioners in 1993) is available here.

Pennsylvania Organ Procurement Organizations

Pennsylvania Department of Health
1-800-PA HEALTH.

The Center for Organ Recovery & Education
(Western Pennsylvania)
204 Sigma Drive
Pittsburgh, PA 15238
Phone: (412) 963-3550 / (800) 366-6777

Gift of Life Donor Program
(Eastern Pennsylvania)
2000 Hamilton Street, Suite 201
Philadelphia, PA 19130-3813
Phone: (215) 557-8090 (610) 543-6391

Update: 06/20/07:

For a discussion about a revision to the underlying law previously enacted in Pennsylvania governing organ donations, see: PA EE&F Law Blog posting "Uniform Anatomical Gift Act in PA Someday?" (06/20/07).

Update: 09/11/08:

For consideration of organ donation from the viewpoints of various religions, see: PA EE&F Law Blog posting "
Religious Views on Organ Donation" (09/11/08).