According to the Coalition on Donation (www.donatelife.net), there are more than 86,000 people awaiting organ transplants in the United States, including hundreds of children, and an average of seventeen people die every day because the organs they need are not available. This scarcity of organs has two main causes: (1) the fragile nature of organs; and (2) a shortage of people who elect to become donors.

In Massachusetts, becoming an organ donor is as easy as checking a box on your next driver's license renewal form and executing a document to let your family and the world know your wishes. The document—which you should execute now, rather than after your next license renewal—can be a Uniform Donor Card, or any signed and witnessed document that expresses your desire to donate. Fill it out, sign it, have it witnessed, and put it in you purse or wallet. Discussing your wishes with family is crucial, so they understand your desire to donate and do nothing to interfere with the process.

For those who worry that becoming a donor may cause medical staff to work less diligently toward a recover, fear not. If you are on artificial support (and would make a good candidate for donating organs), the decision to terminate your support will belong either to your family or to your Health Care Agent. The secondary decision—whether to donate your organs—will belong not to the hospital staff, but, depending on what documents you have or have not executed, to you or to your family. In fact, hospital doctors have nothing to do with the collection of organs from donors and certainly do not control where the organs are sent after they are removed from the donor. The system is managed by regional organ procurement organizations ("OPO") that identify donors and are responsible for the retrieval, preservation, and transportation of the organs to the locations where the transplant will take place (remember, one donor can provide many organs and benefit several people).

If you are a suitable organ donor, but have not executed a Donor Card or other signed witnessed document, the OPO attempts to obtain permission from your family to recover organs for transplant. The order of preference for family consent is the spouse, adult children, parents, and adult siblings. If the family refuses permission, your organs cannot be used, even if you spoke on many occasions about your wish to donate organs. However, if you executed a Donor Card or other signed and witnessed document expressing an intent to donate, and if that Card or document is given to the OPO (if the hospital finds the card in your belongings or if other persons produce the document), then family authorization is not required. This is so because Massachusetts law states that a person can execute a document to make a gift of all or any part of his body, and the gift becomes "effective upon the death of the donor."

Once the OPO obtains permission, from the family or through a witnessed document signed by the potential donor, it brings one or more surgical teams to the hospital to remove the organs (teams specialize in the removal and preservation of specific organs, thus the need for more than one team). The organs are then transported to the location where they are needed.

It is important to note that becoming a donor will not alter your funeral plan in any way and will not cost your family or estate a single penny. There are two exceptions to this general rule, however. First, if your funeral plan calls for an open casket viewing prior to burial or cremation, you might want to limit your donation, in your Donor Card or other signed and witnessed document, to organs and tissue whose removal will not create a detectable change in the appearance of your body.

Second, if you want your body donated to a medical school, you cannot also be an organ or tissue donor (but can still donate your corneas).

(Submitted by the Editor)