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NS-How To Properly Set Organ Donations
Jan L. Warner & Jan Collins

Question: I am a 68-year-old widow and want to donate my organs. My children are most upset with me for making this decision. What do I need to do and can they stop the process after I die?

Answer: You are right on the age line, so if you are going to make this decision, we suggest you make it soon. Once made and you die, short of litigation that is always possible by your children, your decision will be given weight.

First of all, since you wish to be an organ donor or to leave your body to a medical school, there are laws you must follow. You should let your family know about your wishes while you are still alive, which is a good idea. If this letter to your children is not in writing, you should e-mail or write each of them so your capacity will not become an issue later.

Like giving blood, the organ donation system in the United States is strictly voluntary. All states and the District of Columbia have passed what is known as the Uniform Anatomical Gift Act (UAGA). This law basically provides that if you are 18 years of age or older and have the capacity to make the decision, you can make a gift -- effective at death -- of all or part of your body for permitted purposes.

According to federal law, the sale of organs is prohibited. State laws also include a list of people, including certain relatives, court-appointed guardians and other persons who have the right to dispose of your body, to make donations after or immediately prior to death. In some states, if authorized by the terms of a durable power of attorney, your agent is allowed to make the donation.

While an anatomical gift can be made by your will, this is probably not the best idea because your will might not be available at or near the time of death. The better practice, we think, is to include the gift in your healthcare power of attorney, on a card you carry with you or by having your decision to donate indicated on your driver's license. In all states you must sign the gifting document, and some states require witnesses. We suggest your doctor write a letter stating that you had the mental capacity to make the decision.

State laws include a list of acceptable organ recipients, which include medical schools, hospitals, doctors or named individuals. After death and the removal of the organs, the remainder of the body is turned over to the person having the responsibility of ensuring burial, cremation or other arrangements -- generally, the surviving spouse or next of kin.

If you wish to donate your body to a medical school for research, you should make these arrangements directly with the school.

So long as you have capacity, you may change or revoke the gift at any time before death. Because death is such a traumatic time for families, in order to assure that your wishes are carried out you should make your intention to donate your organs or body known to your family. If you don't, your family will be in a position to "veto" your donation decision. Like other aspects of the planning process, full disclosure to family members avoids surprise and helps avert unpleasantness at a time when you can't express your desires.



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