ANNAPOLIS – Spurred by demand that far exceeds supply, a joint task force of the Maryland Legislature is considering major changes in state laws that govern organ and tissue donations.
One proposed change would require hospitals to establish a relationship with organ procurement organizations (OPOs), to contact them in the event of a possible donor, and to delegate all requests for organ and tissue donation to OPO representatives or other “designated requestors.”
Under Maryland law now, hospitals must ask permission of the next of kin in all cases where there is the possibility of organ and tissue recovery and the decedent is not a self-declared donor.
“Required request laws have not met with the success that we had hoped,” said Sen. Paula Hollinger, D-Baltimore County.
During hearings that began in late summer, the task force heard testimony describing perfunctory and half-hearted efforts on the part of hospital personnel to obtain permission.
“What is happening now, far too often, is that we are missing too many opportunities,” said Del. Peter Hammen, D- Baltimore.
Sen. Arthur Dorman, D-Prince George’s, proposed that the new law be called the “Amoss Law,” after the late Sen. William H. Amoss, D-Harford, joint committee co-chairman who passed away October 8.
Hammen said that “I think [legislation] is a fitting tribute to him, because this is something he was very interested in.”
The task force was formed at Amoss’ urging to address the growing numbers of people on waiting lists for organ donation, hospitals with poor recovery rates and cases in which the wishes of people who desired to be organ donors were overriden by their families.
Organs and tissues can only be removed in the case of brain death, while the body is being kept on life support.
As of August 1997, there were over 1,900 people waiting for new kidneys, livers, pancreases, hearts, lungs and intestines at Maryland transplant centers, according to the Transplant Resource Center of Maryland Inc. In 1996, 66 people donated a total of 241 organs.
According to the state Motor Vehicle Administration, nearly 957,000 Marylanders, of 3.7 million licensed drivers, have designated themselves willing organ donors.
One point of debate on the task force is whether a new law should specify that in cases where the deceased had declared himself or herself a donor, the hospital may remove organs without asking permission of the next of kin.
Maryland law states that being designated an organ or tissue donor already represents “sufficient legal authority for the removal of a body organ or part on the death of the donor,” making the consent of the next of kin unnecessary.
“I like this idea of not having to have consent,” said Dorman. “If I’ve made my decision, I don’t want my family to have to give consent.”
However, it is necessary to learn the donor’s medical and social history, which requires cooperation from the family. Moreover, most organ procurement officials ask permission from the family so as to avoid lawsuits and “bad press.”
“I’ve had people say `no’ and then call back the next day and say `I’m sorry — is there anything we can do?'” said Sally Wisniewski, project coordinator at the Brain and Tissue Bank at the University of Maryland at Baltimore.
Other provisions the task force is considering include:
* allowing drivers of ages 16 to 18 to designate themselves organ or tissue donors with the consent of their parents;
* requiring police and paramedics to “take reasonable steps” to get the driver’s license or donor card of accident or trauma victims to the hospital with them;
* placing penalties on hospitals that have failed to establish written protocols for organ recovery or achieved a 90 percent rate of referral after the first year. The task force’s first draft of legislation is expected to be finished and released in about two weeks. -30-