There is more than one way to give someone your heart on February 14th. While Valentine’s Day encourages individuals to share romantic love, February 14th is also National Organ Donor Day. Pledging to literally give your heart (or other body parts) to another individual through organ donation is a unique gift of love.
The Health Resources & Services Administration publishes statistics on organ donation. Here are some of the most recent statistics. One organ donor can save up to eight lives and enhance the lives of over seventy-five more people with the donation of a heart, kidneys, lungs, liver, eyes, and other organs and tissues throughout the body. About 39,000 transplants were performed in 2020. The transplant waiting list is almost three times that number, though, and it is estimated that another person is added to the waiting list every 9 minutes.
There are a variety of ways to designate yourself as an organ donor. Most people make this designation through the Pennsylvania Department of Transportation when they renew their Driver’s License. PennDOT then adds you to the Donate Life Pennsylvania registry of organ donors. You can also sign up directly by going to https://donatelifepa.org/register/. Donate Life Pennsylvania partners with Donate Life America, the Center for Organ Donation & Recovery (CORE), and the Gift of Life Donor Program.
At Keystone Elder Law, we walk clients through organ donation decisions as part of a Health Care Power of Attorney and Living Will document, a copy of which should be provided to your health care providers, so your health care providers have any detailed instructions you may provide about your wishes regarding organ donation. https://keystoneelderlaw.com/advance-care-directive-promotes-free-will/
One comment I hear regularly from clients who are getting older is, “Who would want any of my organs?” They assume because of their age that none of their organs could be used even if they did become an organ donor. I do not have the medical expertise or information to know whether that is true for any specific person, but the donor’s age alone does not mean their organs could not help someone in need. The Health Resources & Services Administration’s statistics include a notation that the oldest organ donor to give a life-saving gift donated his liver at 95 years of age, and it saved a life.
What if you could give someone a hand—literally? The technology for organ and tissue donation has become advanced enough that doctors can successfully connect all of the nerves, blood vessels, muscles, and tissues necessary to attach a real functioning hand, arm, or foot to a patient who would otherwise need a prosthetic. This has been available longer than most people realize. The first successful hand transplant in the United States took place in Louisville, KY in January of 1999. Since that time, there have been other limb transplants for patients across the country who lost limbs for various reasons, including injury in military service and accidents.
This type of transplant is called a Vascularized Composite Allograft (VCA). VCAs are expected to become even more common going forward. In 2018, the Pennsylvania Legislature specifically addressed VCAs, and put in place regulations on what consent is required for a VCA as opposed to the more typical organ donation. Here are some of those provisions:
- The organ donation designation on your driver’s license or on the Donate Life registry is not enough to authorize a VCA donation. The consent to VCAs must be separate from the authorization of other organ donation.
- The statute specifically suggested the consent may be in a will, living will, health care power of attorney, or other document. That document must be in writing, witnessed by two other individuals, and specifically state the authorization of hands, facial tissue, limbs, and other VCAs separate from the authorization of other organ donation. We recommend doing this in a living will or health care power of attorney. Those documents should be provided to your medical providers, so it is more likely the hospital will be aware of them at the time when an anatomical gift can be made.
- It is possible for another person to consent to VCA on an adult’s behalf if the potential donor has died in a hospital or death is imminent. The authorization for VCA will be accepted from the following persons in this order: spouse, adult child, parent, sibling, grandchild, grandparent, any other relative, or a guardian.
- However, no one can override the potential donor’s wishes if it is known the individual would not have consented to this type of transplant. A person who wants to be sure their limbs and facial tissue cannot be donated can accomplish this by designating in a Health Care Power of Attorney or Living Will that they specifically do not authorize VCA donation.
You should be aware that organ donation and VCA donation might have an impact on your other end of life plans. Your family should understand that a medical team may need to keep your body on a ventilator and other apparatus that maintains your organs until a separate team arrives to carry out your organ donation wishes. Families are sometimes alarmed to see what appears to be life support implemented against what they believed to be their loved one’s wishes. Before making your decision, you should consider how any funeral arrangements you or your family would want to have will be affected. Most organ donation will have no impact on funeral arrangements, but the donation of limbs and facial tissue might. Finally, a donor’s identity may not be completely protected due to the presence of birthmarks or fingerprints with VCA transplants.
As you celebrate a relationship on February 14th and throughout the year by exchanging heart-themed gifts with the person you love, think about National Donor Day as well. The loving gift of a heart or other organ could help others keep their loved ones healthy and close to them for years.
Kelly Walsh Appleyard, Attorney