In the Balance
1 July 1996

Who Are the Donors in Organ Donation? The Family's Perspective in Mandated Choice

Publication: Annals of Internal Medicine
Volume 125, Number 1

Abstract

Evidence that families requested to permit organ donation refuse half the time has led to proposals for mandated choice.Under mandated choice, a person's donation wishes would be collected and retrieved at death, and requests to families would be avoided.
There are both ethical and logistic problems with mandated choice.The view of the family should be respected in organ requests, even when patient wishes are known. Public sentiment against overriding family wishes could cause low rates of pro-donation registration. Caregivers have usually refused to take organs when families oppose donation. Logistic issues with mandated choice include the cost and complexity of maintaining a national database on donors and the enforcement of registration. No such database of adults currently exists, even for tax purposes. Two states that have mandated choice programs through departments of motor vehicles report relatively low numbers of pro-donation registrants compared with nondonors or undecided persons. Public education and voluntary donor identification hold more potential to increase donation.

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References

1.
Fox RC, Swazey JP, Watkins JC. Spare Parts: Organ Replacement in American Society. New York: Oxford Univ Pr; 1992.
2.
Joralemon D. Organ wars: the battle for body parts. Med Anthropol Q. 1996; 9:335-56.
3.
Lock M. Transcending mortality: organ transplants and the practice of contradictions. Med Anthropol Q. 1995; 9:390-9.
4.
Siminoff LA, Arnold RM, Caplan AL, Virgnig, BA, Seltzer DL. Public policy governing organ and tissue procurement in the United States. Results from the National Organ and Tissue Procurement Study. Ann Intern Med. 1995; 123:10-7.
5.
Annual Report of the US Scientific Registry for Organ Transplantation and the Organ Procurement and Transplantation Network; 1993.
6.
Spital A. The shortage of organs for transplantation. Where do we go from here? N Engl J Med. 1991; 325:1243-6.
7.
Dukeminier J Jr, Sanders D. Organ transplantation: a proposal for routine salvaging of cadaver organs. N Engl J Med. 1968; 279:413-9.
8.
Stuart FP, Veith FJ, Cranford RE. Brain death laws and patterns of consent to remove organs for transplantation in the United States and 28 other countries. Transplantation. 1981; 31:238-44.
9.
Veatch RM. Routine inquiry about organ donation—an alternative to presumed consent. N Engl J Med. 1991; 325:1246-9.
10.
Spital A. Mandated choice for organ donation: time to give it a try. Ann Intern Med. 1996; 125:00-00.
11.
Overcast TD, Evans RW, Bowen LE, Hoe MM, Livak CL. Problems in the identification of potential organ donors. Misconceptions and fallacies associated with donor cards. JAMA. 1984; 251:1559-62.
12.
Prottas J. Encouraging altruism: public attitudes and the marketing of organ donation. Milbank Mem Fund Q Health Soc. 1983; 61:278-306.
13.
Spital A. Mandated Choice. A plan to increase public commitment to organ donation. JAMA. 1995; 273:504-6.
14.
Klassen AC. Study Design to Evaluate the Effects of State Department of Motor Vehicle Organ Donor Programs on Rates of Organ Donation: Technical Report. Office of Science and Epidemiology, Health Resources and Services Administration, Fall, 1994.

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 125Number 11 July 1996
Pages: 70 - 73

History

Published in issue: 1 July 1996
Published online: 15 August 2000

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Authors

Affiliations

Ann C. Klassen, PhD
From Johns Hopkins University School of Hygiene and Public Health and University of Maryland School of Medicine, Baltimore, Maryland.
David K. Klassen, MD
From Johns Hopkins University School of Hygiene and Public Health and University of Maryland School of Medicine, Baltimore, Maryland.
Corresponding Author: Ann C. Klassen, PhD, Johns Hopkins School of Public Health, 624 North Broadway, Room 729, Baltimore, MD 21205.
Current Author Addresses: Dr. Klassen: Johns Hopkins School of Public Health, 624 North Broadway, Room 729, Baltimore, MD 21205.

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Ann C. Klassen, David K. Klassen. Who Are the Donors in Organ Donation? The Family's Perspective in Mandated Choice. Ann Intern Med.1996;125:70-73. doi:10.7326/0003-4819-125-1-199607010-00011

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