When I took a Gift of Life class back in the 1990s, the principles seemed sound. I displayed the pin with those from Nurses Christian Fellowship and Right to Life.

Twenty years later, Michigan passed the bill for free-standing organ procurement center. I felt uneasy about the loss of local connection, but at the time, I missed the implications of brain-death definitions.

Last week, I attended a continuing education (CE) event on organ donation, and the pieces fell into place. Organ donation has become a mix of the very good, and the truly unthinkable. Change comes from every direction.

In this article I share some items from the CE event, along with information from bill-tracking and Michigan-specific research.

Ethics of Organ Donation are all over the place

The ideal, of course, is living donation. The plan is for both patients to go home healthy when someone donates a kidney, for instance. Cadaver donation of tissues is also uncomplicated ethically for most people, because biologic, cardiac death is evident.

Ethical conflict entered when death was redefined from the biologic shutdown we all recognize, to brain death. This was driven by the desire to transplant organs that require near-continuous bloodflow. Money is a factor, because even in the US where sale is illegal, a body is worth $5 Million in processing charges.

But because circulation, temperature regulation, and other brain and body functions continue, more people are recognizing “brain death” as a legal fiction rather than medical fact.

Current Bills Change Michigan Organ Donation

Currently, Michigan law provides three ways for residents to make an anatomical gift, or donate organs. They may do so in their will; by communicating their wishes at the time of illness or injury; or through driver license procedures at the Secretary of State, who maintains the Donor Registry with access by Gift of Life.

Three bills now in the Michigan legislature would:

1. Revise the Michigan Tax Code. This bill adds a donor registry checkbox to state tax returns, accompanied by an optional tax form to file for joining the donor registry; and directs the Treasury to give these forms to the Secretary of State.
2. Revise the Public Health Code to add this tax filing method of donating organs.
3. Revise the privacy section of the Revenue Act to allow an authorized person in Treasury to disclose donor registration schedules to the Secretary of State’s office, and to Gift of Life.

These bills passed the Michigan House on May 11, with very few opposing votes. (Pages 5-8 of the House Journal.) They are tie-barred, meaning they take effect only if all become law. They await further action in the Senate Health Policy Committee.

Bill Questions to ask

Practically speaking, are the Michigan departments of state and treasury competent to handle this added complexity? Most of us have an opinion about how well they handle our driver licenses and taxes.

My concern, though, is about increasing complexity in Michigan organ donation. It is already heavily layered with federal, state, and public-private bureaucracy that are difficult for individuals to navigate.

Most importantly, what will be the effect on individual rights? Efficient individual care is already a challenge in healthcare.

The bills do not address current problems in the organ donation system, such as whether organ harvesting may take priority over determining possibly-criminal cause of death.

Potentially opening the door to more problems, a Michigan bill last year shifted ultimate responsibility for determining cause of death from county medical examiners and attending physicians, to the MDHHS director. The bill passed the House and reached the floor of the Senate before the end of term. It’s likely to return this term.

Given all the moving parts and the importance of securing the individual right to life, Is now (or ever) the right time to add another layer of organ donation bureaucracy and healthcare records?

Getting removed from the Donor Registry

First, watch the language bias. The organ procurement system emphasizes the “right to donate.”

But the real right, as every survivor of COVID mandates knows, is the right to refuse.

With so much changing, it is impossible to know what the rules will be when it comes time to donate your organs. If the only ones you tell are your family, you’ll find it a lot easier to change your decision to fit new circumstances.

So if you are one of the 50% of Michigan residents who have registered for organ donation, and you’ve changed your mind, here are some tips from my experience.

Peeling the label off a driver’s license is easy. So is skipping the checkbox on the renewal form.
However, changing online records is the real kicker. Ever try to correct an error in your medical record?
Online information never really goes away – but in this case it’s important enough to try.

1. Some say Gift of Life will assist with removing a name from the donor registry. However, when I called they said they aren’t allowed to check the list for names, and referred me to the secretary of state.
2. The secretary of state website says,  “The option to cancel your registration is always available.”
   Unfortunately, “available” and “effective” are two different things.When I attempted to create an account online, it took 10 minutes for the email verification PIN to arrive. When it came, the system did not accept it. After three tries, it locked me out.
   
3. I’m dubious about the mail-in option, since no form is provided. (And why no email address??) So it looks like the local Secretary of State office is next.

Stay informed! Organ donation policy is constantly changing.

Don’t miss the full video of the continuing education event and the organ donation discussion in the MHF Community Forum!

There’s much more about the ethical issues and what you can do. Add your voice and experience to inform, while you learn from others. It’s important – and it’s free.