"Organ donor" on driver's license

[psu_213]

I recently had to renew my driver's license. On a computer screen I was asked (as I was asked by a similar computer before) if I wanted to be an organ donor and have 'organ donor' printed on my license. (In case you are wondering, I said yes, but I don't hold it against anyone if they say no.)

I have had people tell me this essentially makes you an organ donor should something happen to you--i.e. it cannot be revoked by you family members except under the most extreme situations. I have had others tell me that family can override this, so that your organs are not donated even though you have this on your license. So which is....legally binding or still up to your family?

[RNsRWe, ASN, RN]

I can't believe things like that are legal. Someone fills out the proper legal paper work in regards to their wishes, but the doctors are afraid of a lawsuit if they don't go against it? Shouldn't it be the other way around, with them afraid of legal action if they go against those legal documents?

Oh, it's not legal, but the thing is, if they DIDN'T code that old lady, there'd without a doubt be a lawsuit brought by that son. Doesn't matter if he'd win or not (of course not) but during the months/years it was in the court process, there'd be bills to pay and EBTs, depositions, lawyer consults, etc etc etc.

Who'd bring the legal action against the staff for not following the DNR, as you suggest? While you're right, the person who COULD bring that lawsuit is, in fact....dead.

[Cold Stethoscope]

I think most of the time they do go with what your license says opposed to family because you are the one who picked that for your license, so those were your wishes.

This is generally not true, for the reasons RNsRWe points out. The deceased is not able to defend his wishes, and there's little risk of litigation in following the wishes of the family.

[KatieMI, BSN, MSN, RN]

It is state, place and sometimes situation-specific.

In theory, your agreement for procedure expressed as "yes" on an official document should be enough. Practically, because of lawsuit fears, nothing is ever started before "next of kin" available relative(s) contacted. "Yes" mark on driver's licence, practically, only gives the person contacting the family an idea that the donor probably was not totally against organ donation. But it is not a guarantee. I'd seen enough folks who marked "yes" rather authomatically and who'd never discussed the issue with their loved ones precisely because they knew about their families' valiant anti-donation mind setup.

Only one way of overriding these problems is to get legal Power Of Attorney to a most close relative who agrees to do so (not a family friend), preferable within first degree or relationship, who will know the potential donor's opinion and share his/her knowledge and ideas about end of life, formalize the document according to the State's current laws and keep it up-to-date.

[uRNmyway, ASN, RN]

It is state, place and sometimes situation-specific.

In theory, your agreement for procedure expressed as "yes" on an official document should be enough. Practically, because of lawsuit fears, nothing is ever started before "next of kin" available relative(s) contacted. "Yes" mark on driver's licence, practically, only gives the person contacting the family an idea that the donor probably was not totally against organ donation. But it is not a guarantee. I'd seen enough folks who marked "yes" rather authomatically and who'd never discussed the issue with their loved ones precisely because they knew about their families' valiant anti-donation mind setup.

Only one way of overriding these problems is to get legal Power Of Attorney to a most close relative who agrees to do so (not a family friend), preferable within first degree or relationship, who will know the potential donor's opinion and share his/her knowledge and ideas about end of life, formalize the document according to the State's current laws and keep it up-to-date.

I think the problem with things like this is that those who will most frequently fight to keep the patient alive as long as possible ARE those who are closest to the patient. Otherwise, why bother? I guess it is part of the nature of mankind to seek out what is in our own best interests. Whether we follow through or not I guess is probably a result of personal values, upbringing, or part of it, like in my case, is my mother putting the fear of God and hauntings in me

[VictoriaGayle]

Oh, it's not legal, but the thing is, if they DIDN'T code that old lady, there'd without a doubt be a lawsuit brought by that son. Doesn't matter if he'd win or not (of course not) but during the months/years it was in the court process, there'd be bills to pay and EBTs, depositions, lawyer consults, etc etc etc.

Who'd bring the legal action against the staff for not following the DNR, as you suggest? While you're right, the person who COULD bring that lawsuit is, in fact....dead.

I'm just lamenting the "system" that fails so many people. Yes obviously what you said is true, and I'm aware of those factors. I just feel like there should be SOMETHING in place to prevent this kind of thing from happening. The fact that the son would even be able to get that taken to court is disturbing. Its just so sad that there isn't anyone there to stand up for that woman and her wishes.

[Altra, BSN, RN]

Those of you who live in states where the drivers license identification of the patient's intentions are not always enforced ... are you required to report all deaths to your regional OPN (organ procurement network)? This is law in my state -- and is the key to the patient's stated wishes being enforced.

[blueheaven]

I seriously think that the family can override. I did have one patient who explicitly had his wishes placed in his medical record and he also told his family so that they would follow through. Someone has to give consent to harvest. This makes it all the more important to let your family members know your wishes.

[blueheaven]

While I'd say it's technically a "done deal", MDs consider the legal wrangling with an unhappy family and ask them what THEY want done. At least, in my own experience, I can't speak to every State everywhere.

I've seen a DNR completely overridden, because the 90-year old patient (who had signed a DNR while completely in her right mind five years before) was now "incompetent" and the son at her bedside jumped up and down screaming "HELP HER!!!" until the hospital supervisor mobilized the code team. So there she was, coded until she had ribs broken and nothing left except the weakest beat ever....transferred to ICU so she could die again later in the day.

We were all $(#$--ed off about it (I, personally, was able to stay OUT of that room, thankfully)...the son screamed that since he was the Health Care Proxy, he had final right of decision. Medical staff in charge knew that didn't work that way, but figured the poor old thing was going to die regardless...and if they did what he wanted, well, no lawsuit for "negligence"

I can't tell you how many times I've seen what you have described! One problem that I have personal experience with is that many MDs don't have the &^lls to give a straight out answer to the family. Or flat out lie. They give the slightest illusion of hope (no matter what it is) and family will cling to that. This is WRONG!

[Nascar nurse, ASN, RN]

This is generally not true, for the reasons RNsRWe points out. The deceased is not able to defend his wishes, and there's little risk of litigation in following the wishes of the family.

I find this to also be true with any advance directive that may be in place, ie: DNR, end of life care, etc

[ckh23, BSN, RN]

I seriously think that the family can override. I did have one patient who explicitly had his wishes placed in his medical record and he also told his family so that they would follow through. Someone has to give consent to harvest. This makes it all the more important to let your family members know your wishes.

Depends on the state. It is enforced in Pennsylvania and I have seen it used to over ride the family's wishes. However, those instances are far and few between. In my experience, once things are explained to the family about how that was the patient's wish, they are usually more accepting of it and consent. These situations, it is the Gift of Life program that is most involved with the family and explaining the situation.

[That Guy, BSN, RN, EMT-B]

It should be legally binding and protecting in the event that family tries to come back and sue. If the pt has stated they want this done, I feel it is a legal binding document. If anything, action should be taken against the families for breaking that contract.

So much money, time, heartache and trouble would be spared if we actually treated DNR/living wills properly. I have helped keep a poor man alive for 2 months through an NG tube even though he had stated in a living will no feeding tubes. His brother, who never once came to see him, said he wanted him kept alive. Had we actually honored what he wanted, he would have passed in peace instead we tortured that pour soul for so long.

[ckh23, BSN, RN]

It should be legally binding and protecting in the event that family tries to come back and sue. If the pt has stated they want this done, I feel it is a legal binding document. If anything, action should be taken against the families for breaking that contract.

So much money, time, heartache and trouble would be spared if we actually treated DNR/living wills properly. I have helped keep a poor man alive for 2 months through an NG tube even though he had stated in a living will no feeding tubes. His brother, who never once came to see him, said he wanted him kept alive. Had we actually honored what he wanted, he would have passed in peace instead we tortured that pour soul for so long.

Unfortunately some people do this because they can still collect social security checks, pensions, etc. that are meant for the patient. I have seen some families that couldn't care less about the patient just as long as those checks keep coming in.