"Give Me a Few More Minutes!": How Virginia Violates Due Process by Hitting the Snooze Button on a Timely Declaration of Death
I. Background 983 A. Defining "Death" 984 B. "Irreversibility" 986 A. Variation Among States in Determining Death 988 A. Uniform Determination of Death Act Majority Process 988 B. Virginia 's Process, and Another Outlier 990 III. Due Process 993 A. Right to Privacy 994 1. Privacy as a Fundamental Right 994 2. Privacy in Organ Donation 997 3. Compelling Interest 1000 4. Constitutionality 1001 B. Right to Die 1002 1. Death as a Fundamental Right 1002 2. Death in Organ Donation 1005 3. Compelling Interest 1009 4. Constitutionality 1011 IV. Recommendations 1011 A. Joining the Majority 1011 B. Public Policy 1012 Conclusion 1015 Stealing five minutes of extra sleep in the morning is not an unusual way for someone to begin his day. The alarm simply rings again, he gets up, carries on his routine at an accelerated pace, and is no worse for the wear. But sitting back idly while the second hand makes five slow rotations is not always so innocuous. In many instances, minutes - and even fractions thereof - are critical. One context in which snoozing is less acceptable is organ donation. Organs are sustained by the oxygen and nutrients they receive from circulating blood. When an organ donor dies and his heart stops pumping blood, doctors have mere minutes to remove his organs before they are irreparably degraded by lack of blood flow.1 With that in mind, most states have drafted their deam-determination statutes to allow for speedy organ harvesting.2 Not Virginia; Virginia hits the snooze button on organ procurement. Virginia's codification of what constitutes death is very different in one respect from most other states' death statutes.3 Though every state embraces both cardiopulmonary and neurological definitions of death, and every state respects legitimate Do Not Resuscitate (DNR) orders, Virginia has a requirement most states do not have. Virginia commands that before an individual can be declared dead, a physician must determine that artificial cardiopulmonary resuscitation (CPR) would not be successful in resuscitating the individual.4 This is the case even when the individual has a valid DNR order.5 Virginia's law has a tremendous impact on the effectiveness of harvesting organs and implicates potential donors' fundamental rights to privacy and death. Part I of this Note describes the mechanics of and laws pertaining to organ transplantation. This sets the stage for understanding why Virginia's law ought to undergo a constitutional analysis. It examines how the meaning of "death" has evolved over time and scrutinizes critical language within these definitions. These details directly impact the rate at which organs can be recovered. Part II focuses on how Virginia's death-determination criteria differ from the way in which the majority of states interpret the Uniform Determination of Death Act. Part III analyzes the constitutional implications of Virginia's law as compared to the requirements endorsed by the rest of the country. Here, the Note examines the right to privacy and how death-determination statutes affect this fundamental right. …
Organ donation in the United States
presented to The Society for Organ Sharing 2nd International Congress. Vancouver, BC, July 4–6, 1993. Nathan et al. 40 American Journal of Transplantation 2003; 3 (Suppl. 4): 29–40
The impact of a comprehensive, hospital-focused intervention to increase organ donation.
In this article the results of a 2-year intervention designed to increase rates of organ donation while improving services to bereaved families of potential donors are described. The project focused on improving key elements of the organ donation process. The intervention was implemented in 50 hospitals within the service areas of three organ procurement organizations. Results show an increase in identification, referral, and asking rates. The overall donation rate increased significantly, from 33% to 43%. However, consent rates remained unchanged. Future efforts should focus on improving the request process by systematically incorporating practices that are associated with higher consent rates. This should enable hospital and organ procurement organization staff to appropriately and effectively offer families the option of organ donation; further increases in organ donation should follow.