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Bioethicists Art Caplan and Michael A. Devita have written an important column warning against plans that are afoot to increase the organ supply, but which if enacted, would instead be more likely to undermine the already thin crust of trust the people have in the organ procurement system.

Apparently, a proposal is being crafted that would alter the terms of the Uniform Anatomical Gift Act, a “model law” which states often follow in crafting their respective public policies. The proposal would give priority to the signing of organ donor cards. Caplan and Divita explain what this could mean: Their proposal, which is under consideration by states, is that organ donation consent (on a driver’s license, for instance) be allowed to override a person’s living will, advance directive or even physician orders. The proposed language in the revision states, “measures necessary to ensure the medical suitability of an organ for transplantation or therapy may not be withheld or withdrawn from the prospective donor.” What this means is that if you say you are willing to donate your organs, your advance directive, living will and physician’s orders are in trouble. In other words, if these recommendations become law and you sign an organ donation card, preserving your organs could become the primary consideration in determining your medical care—which could either prevent you from receiving treatment you might want, or be forced to accept interventions you would not want.

This is nuts. If people ever come to feel that their organs might be seen as more important than their own medical welfare, they will rip up their organ donation cards en masse. Good for Caplan and Devita for bringing this important matter to public light.

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