Anatomical gift

What it means

Registering as a donor at the licensing agency, or signing a document of gift, is not an expression of preference. Under the uniform act every state has adopted in some form, it is a legally effective gift, and it does not require anybody else's agreement.

That is what registration actually does. Where a valid registration exists, the family is informed rather than asked, and a relative's objection does not revoke it. Where none exists, the decision passes down a statutory list of people, in order, and disagreement between people at the same level is what causes delay at the one moment there is none to spare.

Whole-body donation to a medical school is a separate arrangement with a separate program, usually requiring registration during life, and it is frequently incompatible with organ donation — a body accepted for one may be declined for the other.

Almost nobody is medically ruled out in advance. Age and illness are assessed at the time rather than used as a filter beforehand, so declining to register on the ground of being too old or too unwell is declining on a false premise.

Why it matters

A registration made quietly years ago binds, and a family that does not know it exists experiences it as a decision taken away from them.

Where nothing was registered, the decision falls to the family at the worst possible hour, which is the case for settling it in advance in either direction.

When you are likely to meet it

• When a hospital raises donation, usually within hours.
• When renewing a driving license and being asked.
• When writing down funeral wishes, where this belongs alongside them.

How this varies by state

Every state has adopted a version of the same uniform act, and the order of people who may decide where nothing was registered is set by each state.

Related terms

• Advance directiveA document recording your medical wishes, and naming who should speak for you if you cannot.
• Death certificateThe official record of a death, issued by a state or local vital records office, and the document nearly every organization will ask to see.
• Final dispositionWhat ultimately happens to the body — and the phrase every authorization form uses, which is why it appears on paper before anybody has explained it.
• Health care agentThe person named in a health care proxy to make medical decisions when the patient cannot.
• Letter of instructionAn informal document left alongside a will, saying the practical things a will has no room for.
• Medical examinerThe official who investigates and certifies certain deaths — and whose sign-off everything else waits on.
• Organ procurement organizationThe body that federal designation puts in charge of recovering organs — and, in practice, whoever telephones the family in the first hours.

Sahvelo guidance that uses this

• Organ donation