Advance Care Directives

There are three kinds of documents that may provide evidence of a person’s wish to donate his or her organs in the event of that person’s death. These are:

  • Living wills: Living wills provide instructions for someone’s medical care if that person becomes incapacitated or otherwise unable to make decisions himself or herself. State statutes regulate living wills. In most cases, a living will can direct that one’s organs or tissues be taken and donated if medically appropriate. If individuals execute a living will, it is advisable for them to inform their physicians and their families of its existence.
  • Durable powers of attorney for health care. A durable power of attorney for health care names someone, the individual’s “agent,” to make important decisions regarding that person’s health care should the person become incapacitated. These documents can instruct the person’s agent to donate the person’s organs or tissues upon the person’s death. As with living wills, the durable power of attorney for medical care is only effective if, in addition to the agent, the family and the person’s physician know of its existence.
  • Advanced care medical directive: An advance care medical directive (ACMD) combines some features of the living will and the durable power of attorney for health care. An ACMD allows individuals to provide instructions for the type of care they do or do not want in a number of medical scenarios. These documents need to be created in consultation with their physician(s).

Several states have passed laws that presume consent of a decedent (to donate organs or tissues) in certain limited circumstances. These laws are very limited in scope. Despite these statutory provisions, the best way to insure that a person’s organs or tissues will be made available for transplantation after his or her death is for the person to let relatives know of his or her desire to donate. This is especially true when one considers that medical personnel rely so heavily on the wishes of the next of kin when deciding whether to harvest useful organs.

Competent living persons may donate renewable tissues (e.g. blood, platelets, plasma, and sperm), and those not essential to the donor’s health (e.g. eggs). However, a person may not donate organs or tissues necessary for sustaining the donor’s life (e.g. heart, lungs, liver). There are two more ways to let others know of about one’s decision to donate. First, the person can complete an organ donor card, or sign the back of the person’s driver’s license. Second, the person can execute a living will, durable power of attorney for medical care, or create an advance care medical directive informing the prospective medical care provider of the extent of care the person wishes to receive prior to the death. This document will also provide specific instructions for the disposition of the person’s body after death, including donating your organs. By taking these steps, individuals are best assures that their decision to become an organ and/or tissue donor will be fulfilled.


Inside Advance Care Directives