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Dilemmas in Organ Donation
Dilemmas Cited In Removing Organs
January 17, 2001
CHICAGO (AP) - Deciding you want to donate your organs after death is no guarantee it will
happen, especially if your relatives object.
A government survey of the nation's 61 organ procurement organizations found wide variations in
how they decide whether to remove organs from the dead for transplant. Just 29 of the groups
have an official policy on whether to follow the wishes of the deceased or of family members.
If a person had indicated in a living will or on a donor card that he wanted to be a donor but his
survivors opposed it, only seven groups - 12 percent - said they would probably remove the
Fifty-two of the groups surveyed - 85 percent - said they rarely have documentation of the
deceased's wishes. And when they do, 51 of them - 84 percent - said families do not always go
along with the deceased's wishes.
Every state has adopted some form of the Uniform Anatomical Gift Act, which favors the wishes
of donors. But Susan Gunderson, president of the Association of Organ Procurement
Organizations, said laws generally give wide latitude to procurement groups.
The private organizations surveyed in 1999 are in charge of organ procurement from cadavers
throughout the country. The survey was done by Dave Wendler and Neal Dickert of the National
Institutes of Health's department of clinical bioethics and was published in Wednesday's Journal of
the American Medical Association.
Procuring organs from the deceased is a delicate process, fraught with emotion for all involved,
said Phil Van Stavern of the Oklahoma Organ Sharing Network, one of the procurement groups.
Typically, the prospective donor has died suddenly and unexpectedly. Procurement coordinators
often enter the scene in the hospital waiting room, where survivors have just learned of their loved
``The family's in shock, they're grieving, and we're being very invasive,'' Van Stavern said.
Defying the family's wishes under such circumstances is very difficult, he said.
To ease the process, prospective donors should ``make sure they tell their family what their
wishes are,'' both orally and in writing, Van Stavern said.
The findings come amid efforts to address the nation's scarce supply of transplant organs.
In 1999, for example, 6,448 of 72,255 people on transplant waiting lists died by the end of the
year while awaiting an organ, according to the United Network for Organ Sharing, which runs the
nation's transplant network.
A national debate has focused on how to distribute donated organs, but most people agree that
the best solution is to increase donation. In a JAMA editorial, University of Southern California
ethicist Alexander Capron said the survey bolsters suggestions that weaknesses in the
procurement process have contributed to the shortage.
Copyright 2001 The Associated Press. All rights reserved.