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Colorado May Make Organ Donation Approval Automatic
Colorado Would Be First In Nation
By Dayle Cedars, 7NEWS Reporter

POSTED: 8:55 am MST January 19, 2011
UPDATED: 10:15 pm MST January 19, 2011

DENVER -- Some Colorado lawmakers say their state should be the first one where people become organ donors by default, even though other states' efforts have been halted by worries about making such a personal decision automatic.

Colorado's proposal, introduced in the Legislature last week, would change the process for renewing driver's licenses and ID cards so applicants are assumed to be organ and tissue donors unless they initial a statement that says they want to opt out.

The "presumed consent" system is common in Europe and is credited with dramatically raising donation rates.

In the U.S., however, similar approaches have been defeated by lawmakers in at least three states -- Delaware, Illinois and New York -- because of concerns that donation programs seem coercive if they require residents to say no.

Organ donation advocates hope for a warmer reception in Colorado, where nearly two-thirds of people carrying driver's licenses or state-issued IDs volunteer as donors -- a higher rate than in any other state.

One of the bill's sponsors, Democratic Rep. Daniel Pabon of Denver, said the change would simply make it easier for people already willing to donate their organs when they die. The current system relies on Division of Motor Vehicles employees to ask each person who applies for a license or ID.

"This takes a bunch of people who otherwise might donate but just get in the DMV and don't want to stand in line, or they forget, and this makes it easier," said Pabon, whose uncle received a liver transplant after three years on a waiting list in Iowa.

Yet, Donor Alliance, an organ and tissue recovery agency isn't backing the bill.

"I don't think it should pass right now," said Sue Dunn, CEO of Donor Alliance. "And that is an awkward for me to say running an organ and tissue recovery agency."

Dunn said Donor Alliance supports the concept, just not this particular bill, the way it is written.

Applicants would see a statement that says, "You are automatically deemed to have consented to being an organ and tissue donor and this designation will appear on your driver's license or identification card."

Opponents of Delaware's 2008 bill called it an intrusion into people's privacy that treats organs as commodities. People against the opt-out method argue that presumed consent could force someone to become a donor against their will. Some people fear a medical team won't work as hard to save them if there is a greater benefit to harvesting the organs.

Dr. Jackie Glover, of CU Anschutz Medical Center in the Center for Bioethics and Humanities said there are pros and cons to such legislation.

"It seems coercive," said Glover. "It is not voluntary if you don't ask me."

Glover said if this law took effect, the same problems people who want to opt-in now face, would then affect people trying to opt-out.

"The same barriers could be a concern," said Glover. "I wanted to opt out but I didn't want to wait in those lines. I didn't know how to opt-out. They are reversing the argument."

Pabon noted that Coloradans already seem to embrace organ and tissue donation with a donor volunteer rate that leads the nation, even though the state doesn't offer discounts on state IDs for donors, as some states do. About 65.6 percent of people with Colorado licenses or IDs, or more than 2.9 million people, are volunteer donors, state officials said.

"This issue Bs one that's ripe for Colorado," Pabon said of his presumed consent proposal.

Despite Colorado's donation-friendly environment, organ donation advocates say the state still doesn't have enough donors to meet demand.

"After people pass away, there's a way to save nine lives, 10 lives with organ and tissue donations," said Steve Farber, a Denver attorney who received a kidney transplant from his son and co-wrote "On the List: Fixing America's Failing Organ Transplant System."

Farber, who founded the American Transplant Foundation, hasn't yet taken a position on Colorado's opt-out proposal. Even if Colorado raises organ and tissue donations through an opt-out system, there would still be a shortage because medical demand far outpaces supply, he said.

Arthur Caplan, of the University of Pennsylvania's Center for Bioethics, agreed that waiting lists aren't going away.

"The demand for organs is growing so fast that even if we do this, we're not going to meet the shortage," said Caplan, one of the nation's most prominent supporters of opt-out donation programs.

He had some advice for Colorado lawmakers supporting the change: Replace the "presumed consent" title on the bill with a better-sounding "default to donation." Caplan says the phrase "presumed consent" sounds Orwellian to some.

"When you use the word 'presumed' it sounds like you're just going to take the organ, and that doesn't sound good," said Caplan, who last year argued in favor of New York's failed attempt at presumed consent.

Dunn said in order for such a bill to work, community discussions need to be had in order to make sure there is support for such a drastic change.

"To change the system so dramatically, even though we have the highest opt-in rates in the country, I think it is really important that we get the religious, the ethical, the legal -- our diverse communities to weigh in and have a broad discussion," said Dunn.

Dunn even said it's possible the law could actually hurt organ donation in the state.

"What we don't know and what has not been shown in any state in the country, is will rates go up or down," said Dunn. "Would the way that it gets presented at the driver's license office actually increase the number of people who say no?"

Donor Alliance is scheduled to meet Thursday with Senator Lucia Guzman, who introduced the bill.


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