Posts Tagged ‘organ transplant’

Are You an Organ Donor? Are You Sure?

JULY 15, 2013 VOLUME 20 NUMBER 26

Do you have strong feelings about being an organ donor? It is a topic that too often goes undiscussed while preparing your estate plan. That’s one time to consider whether you want to be an organ donor — particularly if you have meant to address it but haven’t gotten around to the topic.

You probably remember the last trip you took to update your driver’s license, but maybe you cannot remember if you ever registered to be an organ donor. Or perhaps, you’re a registered donor, but have not had a conversation with your friends and family about your decision to donate. Maybe you feel strongly that you do not want to donate your organs. In each of those circumstances, it is important to make your wishes clear and to talk with your family and your attorney about the topic.

The National Conference of Commissioners on Uniform State Laws adopted The Uniform Anatomical Gift Act in 1968 and went on to revise the Act most recently in 2006.  Arizona is one among over forty states that adopted the newer version of the Act. Arizona Revised Statutes §§36-841 (and the 20-or-so following statutory sections), lays out the groundwork for making an organ donation in the state. Arizona is unique in that it is one state where a donor may register and select what specific organs he or she wishes to donate.

But how do you become an organ donor in Arizona? If you are 18 years or older, you can become a donor by registering with Donate Arizona, or including written instructions in your will. Additionally, you can include language in your power of attorney that authorizes your Agent to consent to donation. Even if you never register, you can still become a donor if you include language in your will or power of attorney providing your agent with authorization to donate on your behalf. It is never too late to sit down and make your wishes clear.

Kris Patterson, with the Donor Network of Arizona, encourages people to do three important things if they wish to donate: register with a local network; talk to your family and friends about your desire to become a donor; and let your doctors determine whether you are a good candidate to donate.  She explained that people frequently assume that they are too old to donate, or rule out registering to become a donor because they have a bad heart or bum hip. When it comes down to it, there is no litmus test that identifies whose organs can be used.

The Act lists people in order of priority who may provide consent upon your death to become (or not become) a donor. The person who you appoint as your Agent under your power of attorney is first in line. If you do not appoint an Agent, the Act provides that a family member, a guardian, or friend, and in certain cases, even a domestic partner can share your decisions about organ donation with medical personnel after your death. As a last resort, you can always include instructions about organ donation in your will.

So, take a moment to think, have you made a decisions about organ donation? If so, does your family know? Have you been thinking about making an appointment to update your old will or power of attorney? If so, when you come in to see us, let’s talk about organ donation and make sure that your documents reflect your decisions.

Executive summary:

Want to make sure you are an organ donor? If you are an Arizona resident, do these three things:

  1. Fill out the Arizona donor registration form. Include any special provisions (like approval or refusal for individual organs, preference for transplant over research or the reverse, or anything else you feel strongly about).
  2. Include a provision authorizing organ donation in your health care power of attorney.
  3. Talk with your family — especially the agent on your health care power of attorney AND any family member who might not approve of organ donation.

Want to make sure you are NOT an organ donor? Do these two things:

  1. Make your wishes clear in your health care power of attorney (and maybe in your will as well).
  2. Talk with your family — especially the agent on your health care power of attorney AND any family member you think might really want to approve organ donation.



Patient’s Right To Refuse Blood Upheld, Though Posthumously


Maria Isabel Duran was a devout Jehovah’s Witness. The 34-year-old New York woman believed, along with most members of her faith, that the Bible prohibits transfusions of blood or blood products, even when life is threatened.

Ms. Duran also needed a liver transplant operation. Her faith does not teach that organ transplants are prohibited, and so Ms. Duran searched for a medical facility that would recognize her medical and spiritual needs. She learned that the University of Pittsburgh Medical Center had performed transplants on Jehovah’s Witnesses without transfusions.

Knowing that her husband did not share her religious convictions, Ms. Duran took precautions to ensure that she would not receive blood transfusions. She named a friend as her agent for health care decisions, and her health care power of attorney included strong language making her refusal clear. “I absolutely, unequivocally and resolutely refuse homologous blood (another person’s blood) and stored autologous blood (my own stored blood) under any and all circumstances, no matter what my medical condition,” wrote Ms. Duran (the provisions in bold print here were in bold in her original power of attorney).

Immediately after the 1999 transplant Ms. Duran’s body began to reject her new liver, and her condition declined precipitously. She lapsed into a coma, and her health care agent was called upon to consent to a second transplant operation. Before that operation Ms. Duran’s physicians decided that she needed an immediate transfusion.

Presumably realizing that Ms. Duran’s health care agent would refuse permission for a blood transfusion, her husband instead filed an emergency guardianship proceeding with the Pennsylvania courts. An attorney was appointed to represent Ms. Duran, and her physician, husband and sister all testified to the need for a blood transfusion. Her health care agent was not notified about the legal proceeding. After a brief hearing the judge approved transfusions. Ms. Duran’s health care agent objected, but transfusions continued during the ensuing legal maneuvers. Ms. Duran died three weeks later.

Despite the death of Ms. Duran her health care agent pursued an appeal of the order permitting transfusions. Recognizing that the situation could arise again, and that it was important to have some legal resolution of the dispute, the Pennsylvania Superior Court accepted jurisdiction of the case.

That court ruled that the crystal-clear language of Ms. Duran’s health care power of attorney should have been enforced. Furthermore, Ms. Duran’s health care agent was entitled to be notified of the proceedings and defend her wishes in court. Although Ms. Duran did not survive the operation or the legal proceedings, her case reinforces the right of patients to control their own treatment. In Re Duran, February 21, 2001.

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