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Laws & Regulations on Organ Donation

With more than 100,000 people on waiting lists to receive organs that could save their lives, according to the United Network of Organ Sharing, organ donors are in demand. Although growing numbers of people are opting to participate in donation programs, the issue remains a controversial one. In the U.S., regulation of organ donation varies by state, but the goal of each set of laws is similar: protect the best interests of donors and their families while making as many viable organs as possible available to patients who need them.

  1. Organ Registry

    • A 1984 federal law created a national organ donation registry, which is overseen by a private nonprofit organization, the United Network for Organ Sharing (UNOS). The organization operates a database of registered donors and patients in need of transplanted organs. It also runs an organ center that is open and fully staffed 24 hours a day, every day of the year, as required by the 1984 law. The UNOS Organ Center gathers donor information, runs that information through its database of waiting recipients, finds the most qualified match, and helps transport organs and tissues.

    Who Can Give

    • In general, state laws allow people of any age to register for organ donation, although minors must get parental consent. In some states, you may include your status as an organ donor on your driver's license. In other states, donors carry a separate card on their persons. In either case, donors are expected to share their decision with family members, because some states require relatives to sign a consent form before donated organs can be collected. Most states bar people with certain infections or diseases from donating their organs, including people with HIV or active brain cancer.

    Who Can Receive

    • UNOS maintains a national database of all patients awaiting transplants. Its system aims to assure that the sickest person gets top priority and that no candidate gets preferential treatment. When an organ becomes available, registry specialists consider a variety of factors to decide which candidate is the best match. Match criteria include blood type, organ size, urgency of the patient's condition, time spent on the waiting list, and how far away the patient is from the organ. Patients must also be medically stable enough to undergo surgery immediately.

    General Restrictions

    • Laws on the state and national level protect people from being coerced into donating organs. They also safeguard organ donors from having their decisions reversed after their deaths. Many states have adopted the Uniform Anatomical Gift Act, which forbids the sale of human organs in the United States. The act mandates that hospital workers ask families about a deceased patient's status as an organ donor, and it prioritizes a patient's decision over the wishes of loved ones after his death.

    Ethical Considerations

    • Faced with a shortage of donated organs and growing lists of patients in need, the U.S. Department of Health and Human Services launched a federal campaign in 2003 to spur organ procurement organizations to raise awareness about organ donation, identify more donors and recover more organs. The plan was successful in creating a 67 percent increase in organ donors between 1995 and 2006, but it also sparked concerns from ethicists, religious leaders and citizens who feared the campaign would promote organ donation too aggressively.

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