State law governs postmortem organ donations under the original (1968) or revised (1987) Uniform Anatomical Gift Act. These acts have been adopted in every state, although there are some minor variations among the states’ laws. Basically, the laws state that competent adults may make gifts of an organ or organs in the event of their deaths. The organs may be used for transplantation, research, or education. If there is no explicit anatomical gift made by a decedent, the decedent’s family may consent to harvesting of the decedent’s organs.

The Uniform Anatomical Gift Act (AGA) has been adopted in various forms by all 50 states. These laws state that a wallet-sized donor card, signed by a person over 18 and witnessed by two other adults, is a legal instrument permitting physicians to remove organs after death. These cards are often part of state driver’s licenses. When the AGAs were passed, there was great hope that they would help to dramatically increase the supply of organs. Unfortunately, donor cards have not produced a significant increase in the supply of organs. There are at least two reasons for their failure to bring about the hoped-for increase in the supply of transplantable organs:

• Many people do not sign the donor cards or do so incorrectly
• Despite being recognized as a legal document, many medical professionals have been reluctant to rely upon the donor card for permission to remove organs from decedents for transplantation purposes