NCPA - National Center for Policy Analysis


June 22, 2005

The American Medical Association (AMA) says that a controversial proposal to boost organ donation merits study. It's called "presumed consent": Anyone who dies would automatically be considered an organ donor, unless he or she had previously registered an objection.

During its annual meeting in Chicago, the AMA recommended pilot studies in relatively small populations to determine whether presumed consent would increase organ donations.

  • Presumed consent is in effect in some countries in Europe and South America.
  • Presumed consent laws for organ transplants have been introduced in several states, but none has passed.
  • Several states have passed presumed-consent laws for cornea transplants, but courts have split on whether such laws are constitutional.

Currently, a person is considered an organ donor if he or she has expressly indicated a willingness to donate. In the absence of such consent, next of kin generally have the authority to donate.

Opponents have several objections:

  • Presumed consent violates Americans' traditional right to make decisions for themselves.
  • It could be perceived as "culturally or religiously insensitive," an AMA report noted; for example, presumed consent could increase some minorities' mistrust of the health care system.
  • Any system to register objections to organ donation is bound to miss some people; for example, a non-donor could opt out while renewing a driver's license -- but not all adults get licenses.

The AMA also endorsed pilot studies on an alternative to presumed consent, "mandated choice." Under this option, people would be required to express their wishes on organ donation while renewing drivers' licenses or doing other government-mandated tasks.

Source: Jim Ritter, "Don't want to give organs? You might have to say so," Chicago Sun-Times, June 21, 2005.


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