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Who Can Consent to Organ or Tissue Donation If I’m Not a Registered Donor?
Although state laws may vary somewhat, under the Revised Uniform Anatomical Gift Act a designated healthcare agent or next of kin can consent to organ donation for a person who […]
Although state laws may vary somewhat, under the Revised Uniform Anatomical Gift Act a designated healthcare agent or next of kin can consent to organ donation for a person who did not consent before their death. The act defines the decision-making hierarchy as follows:
- Healthcare agent or Power of Attorney
- Spouse
- Adult children
- Parents
- Adult Siblings
- Adult grandchildren
- Grandparents
- Adults who exhibited special care or concern, except those who provided compensated health care for that individual (for example, a doctor)
- Legal guardian
- Whoever has the legal authority to dispose of the body
In some states, however, one individual may not make the determination if another person in the same class objects (for example, two adult children disagree). If that is the case, the majority of individuals in that class or subsequent classes must agree before the donation can proceed. So, for example, if three adult children survive the deceased and there is no surviving spouse, two of the surviving children must agree to donate the person’s organs over the objections of the third before the process can proceed. If there are only two adult children and they disagree, a parent of the deceased person can “break the tie.”
Additionally, according to the National Academies of Sciences Engineering Medicine, many states allow a medical examiner or coroner to remove corneas from bodies that have come under their authority (for example, to perform an autopsy to determine the cause of death). These laws do not require express consent of the family or the person who has died.
Can Family Override Consent?
If an individual specified their desire to donate organs or tissue in an advance directive for healthcare or a legally executed will or was registered as a donor with the state, they are said to have granted “first-person consent” for donation after death. In every state in the U.S, the next of kin and/or authorized healthcare agent are barred from revoking first-person consent unless they have proof that the person revoked consent themselves. The only exception to this rule is if the potential donor was an unemancipated minor (for example, a 16-year-old child who signed up on the donor registry when acquiring a driver’s license). In that case, one or both parents may revoke consent.
With that being said, if you want to be an organ and/or tissue donor, tell your family, your healthcare agent, and your friends. This is the best way to avoid conflict and confusion at an already difficult time. It will also give you an opportunity to explain why donating is important to you and discuss any questions your family may have. The process goes much more smoothly and will be less traumatic for everyone involved if your family knows your wishes in advance.
Sources
“Presumed Consent”. National Academies: Sciences, Engineering, Medicine. https://nap.nationalacademies.org/read/11643/chapter/9#228
“First Person Consent”. United Network for Organ Sharing. https://unos.org/wp-content/uploads/unos/registires_combined.pdf
