The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the

Uniform Act In the United States, a uniform act is a proposed state law drafted and approved by the Uniform Law Commission (ULC), also known as the National Conference of Commissioners on Uniform State Laws (NCCUSL). Federalism in the United States traditi ...

s drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), also known as the

Uniform Law Commission The Uniform Law Commission (ULC), also called the National Conference of Commissioners on Uniform State Laws, is a non-profit, American unincorporated association. Established in 1892, the ULC aims to provide U.S. states (plus the District of Co ...

(ULC), in the

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with the intention of harmonizing

state law State law refers to the law of a federated state, as distinguished from the law of the federation of which it is a part. It is used when the constituent components of a federation are themselves called states. Federations made up of provinces, cant ...

s between the states. The UAGA governs

organ donation Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin. Donation may be for re ...

s for the purpose of transplantation. The Act permits any adult to become an organ donor. It also governs the making of anatomical gifts of one's

cadaver A cadaver or corpse is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Stud ...

to be

dissected Dissection (from Latin ' "to cut to pieces"; also called anatomization) is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause ...

in the study of

medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...

. The law prescribes the forms by which such gifts can be made. It also provides that in the absence of such a document, a surviving

spouse A spouse is a significant other in a marriage. In certain contexts, it can also apply to a civil union or common-law marriage. Although a spouse is a form of significant other, the latter term also includes non-marital partners who play a social ...

, or if there is no spouse, a list of specific relatives in order of preference, can make the gift. It also seeks to limit the liability of

health care provider A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive ...

s who act on

good faith In human interactions, good faith ( la, bona fides) is a sincere intention to be fair, open, and honest, regardless of the outcome of the interaction. Some Latin phrases have lost their literal meaning over centuries, but that is not the case ...

representations that a deceased patient meant to make an anatomical gift. The Act also prohibits trafficking and trafficking in human organs for profit from donations for transplant or therapy. The UAGA provides a template for the

legislation Legislation is the process or result of enrolled bill, enrolling, enactment of a bill, enacting, or promulgation, promulgating laws by a legislature, parliament, or analogous Government, governing body. Before an item of legislation becomes law i ...

to adjust

public policy Public policy is an institutionalized proposal or a decided set of elements like laws, regulations, guidelines, and actions to solve or address relevant and real-world problems, guided by a conception and often implemented by programs. Public p ...

and align it with developments in medical practice. Some states have their own version of the UAGA which is an updated version of the Uniform laws already enacted throughout the United States.

History

There were three versions of the Uniform Anatomical Gift Act that were enacted; the first was the UAGA of 1968, which was followed up with revisions in 1987. The most recent version was created in 2006. The Uniform Anatomical Gift Act has been established in some form, in every state and the District of Columbia (D.C.), as of 2017. The law has been revised to make the process of making an anatomical gift more streamlined, and to promote

to citizens in order to address the high demand for donated organs for transplantation. The demand for donated organs is extremely high due to the fact that a large number of people die while waiting for an organ transplant in the United States. As of 2016, there were fewer registered organ donors than people in need of an organ or tissue transplant. Formerly, anatomical gifts had to be executed with

testamentary A testator () is a person who has written and executed a last will and testament that is in effect at the time of their death. It is any "person who makes a will."Gordon Brown, ''Administration of Wills, Trusts, and Estates'', 3d ed. (2003), p. 556 ...

formalities, including the creation of a written document with two

witness In law, a witness is someone who has knowledge about a matter, whether they have sensed it or are testifying on another witnesses' behalf. In law a witness is someone who, either voluntarily or under compulsion, provides testimonial evidence, e ...

es; the latest version of the statute eliminates the requirement of the witnesses.

Medical examiners The medical examiner is an appointed official in some American jurisdictions who is trained in pathology that investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdicti ...

and medical professionals who cared for a patient upon their death were previously permitted to remove a part of a body if there was no known

next of kin A person's next of kin (NOK) are that person's closest living blood relatives. Some countries, such as the United States, have a legal definition of "next of kin". In other countries, such as the United Kingdom, "next of kin" may have no legal d ...

, or if the body was unidentified. This change is to encourage the practice of allowing an anatomical gift to be made by a notation on a

driver's license A driver's license is a legal authorization, or the official document confirming such an authorization, for a specific individual to operate one or more types of motorized vehicles—such as motorcycles, cars, trucks, or buses—on a public ...

The Uniform Anatomical Gift Act of 1968

The first Uniform Anatomical Gift Act was created after the first successful

heart transplant A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. , the most common proce ...

in 1967; the operation was performed by Dr. Christiaan Barnard. In 1968, Congress approved the UAGA and recommended that all states adopt it. The Act was the first

enacted by all states in

to address the donation of organs, tissues, and eyes as

gifts A gift or a present is an item given to someone without the expectation of payment or anything in return. An item is not a gift if that item is already owned by the one to whom it is given. Although gift-giving might involve an expectation ...

to someone who may be in need of an organ for survival. The UAGA was drafted in order to increase organ and blood supplies and donation and to protect patients in the United States. It replaced numerous state laws concerning transplantation and laws lacking a uniform procedure of organ donation and an inadequate process of becoming a donor. All states adopted the original version of the law.

The Uniform Anatomical Gift Act of 1987

In 1987, the Uniform Anatomical Gift Act of 1968 was revised so that there was a uniform manner of obtaining

consent Consent occurs when one person voluntarily agrees to the proposal or desires of another. It is a term of common speech, with specific definitions as used in such fields as the law, medicine, research, and sexual relationships. Consent as und ...

from individuals. At this time, every state enacted at least some part of the UAGA. The provisions of the UAGA of 1968 would ban the purchase and sale of body parts, facilitate the simplified process of obtaining authorization to retrieve organs, and ensure that medical staff establish procedures and guidelines to identify

organ donors Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin. Donation may be for re ...

while under hospital care. The Act also characterized a body part or organ as

property Property is a system of rights that gives people legal control of valuable things, and also refers to the valuable things themselves. Depending on the nature of the property, an owner of property may have the right to consume, alter, share, r ...

because of the ability of a living individual to gift parts of their body to another individual. Another major statement that this revised version of the UAGA made was that a coroner's investigation or an

autopsy An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...

could not be obstructed by an individual's wish for organ donation. The 1987 UAGA regulated organs for the purposes of transplantation or therapy. In addition, the individual's wishes to donate were prioritized over the family's or next of kin's wishes. Hospitals were authorized to retrieve organs if an individual was found to have documentation of consenting. The Act's revisions were enacted by 26 states:

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Arizona Arizona ( ; nv, Hoozdo Hahoodzo ; ood, Alĭ ṣonak ) is a state in the Southwestern United States. It is the 6th largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona is part of the Fou ...

Arkansas Arkansas ( ) is a landlocked state in the South Central United States. It is bordered by Missouri to the north, Tennessee and Mississippi to the east, Louisiana to the south, and Texas and Oklahoma to the west. Its name is from the Osage ...

California California is a U.S. state, state in the Western United States, located along the West Coast of the United States, Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the List of states and territori ...

Hawaii Hawaii ( ; haw, Hawaii or ) is a state in the Western United States, located in the Pacific Ocean about from the U.S. mainland. It is the only U.S. state outside North America, the only state that is an archipelago, and the only stat ...

Idaho Idaho ( ) is a state in the Pacific Northwest region of the Western United States. To the north, it shares a small portion of the Canada–United States border with the province of British Columbia. It borders the states of Montana and Wyom ...

Indiana Indiana () is a U.S. state in the Midwestern United States. It is the 38th-largest by area and the 17th-most populous of the 50 States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th s ...

Iowa Iowa () is a state in the Midwestern region of the United States, bordered by the Mississippi River to the east and the Missouri River and Big Sioux River to the west. It is bordered by six states: Wisconsin to the northeast, Illinois to the ...

Minnesota Minnesota () is a state in the upper midwestern region of the United States. It is the 12th largest U.S. state in area and the 22nd most populous, with over 5.75 million residents. Minnesota is home to western prairies, now given over to ...

Montana Montana () is a state in the Mountain West division of the Western United States. It is bordered by Idaho to the west, North Dakota and South Dakota to the east, Wyoming to the south, and the Canadian provinces of Alberta, British Columbi ...

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New Mexico ) , population_demonym = New Mexican ( es, Neomexicano, Neomejicano, Nuevo Mexicano) , seat = Santa Fe , LargestCity = Albuquerque , LargestMetro = Tiguex , OfficialLang = None , Languages = English, Spanish ( New Mexican), Navajo, Ker ...

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, the U.S. Virgin Islands,

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, and

Wisconsin Wisconsin () is a state in the upper Midwestern United States. Wisconsin is the 25th-largest state by total area and the 20th-most populous. It is bordered by Minnesota to the west, Iowa to the southwest, Illinois to the south, Lake M ...

The Uniform Anatomical Gift Act of 2006

Summary

In 2006, The Uniform Anatomical Gift Act was revised with three main goals: motivating more of the population to make anatomical gifts, making honoring an individual's wishes to donate a priority, and maintaining the current organ donation and transplantation system in the United States. It also has the purpose of setting rules and guidelines for determining the purposes that one had for choosing to make a gift as well as the purpose of the gift of an organ, eye, or tissue itself. The UAGA was revised to accommodate the developments in medicine and science regarding organ donation and transplantation, as well as the regulations of donation and transplantation with the goal of increasing the supply of gifted organs. The Uniform Anatomical Gift Act of 2006 was revised to make the laws governing anatomical gifts more uniform between states that had enacted and continued to enforce the UAGA of 1968 and ones that had enacted the revised UAGA of 1987, leading to more consistency.

Revisions

The UAGA of 2006 allows for individuals to consent to organ donation by expressing their wish when obtaining a

, through verbal expression, by writing it in a

will Will may refer to: Common meanings * Will and testament, instructions for the disposition of one's property after death * Will (philosophy), or willpower * Will (sociology) * Will, volition (psychology) * Will, a modal verb - see Shall and will ...

or other

advance directive An advance healthcare directive, also known as living will, personal directive, advance directive, medical directive or advance decision, is a legal document in which a person specifies what actions should be taken for their health if they are no ...

, or in any other manner, simplifying the consent process. This is also known as "opting in" to organ donation. In some states, one may register to become an

organ donor Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin. Donation may be for re ...

online on a state's Donor Registry website, and an individual is permitted to choose which organs they wish to donate by checking boxes. An important addition to the UAGA of 2006 was the strengthening of certain language regarding one's right to make a decision for themselves pertaining to consent of organ donation, making it harder for others to try to nullify one's wish to consent after their death. The only exception allowing an individual's consent to donate to be overridden is in the case of the death of a

minor Minor may refer to: * Minor (law), a person under the age of certain legal activities. ** A person who has not reached the age of majority * Academic minor, a secondary field of study in undergraduate education Music theory *Minor chord ** Barb ...

when parents or

guardians Guardian usually refers to: * Legal guardian, a person with the authority and duty to care for the interests of another * ''The Guardian'', a British daily newspaper (The) Guardian(s) may also refer to: Places * Guardian, West Virginia, Uni ...

may override the minor's consent. Language in the Act is also made more clear so that one cannot revoke an anatomical gift as the donor's decision is final. This revised UAGA additionally created legislation allowing certain people to make an anatomical gift to another person while the donating individual is still alive. It is stated that it's the duty of

law enforcement officer A law enforcement officer (LEO), or peace officer in North American English, is a Public sector, public-sector employee whose duties primarily involve the Law enforcement, enforcement of laws. The phrase can include campaign disclosure specialist ...

firefighter A firefighter is a first responder and rescuer extensively trained in firefighting, primarily to extinguish hazardous fires that threaten life, property, and the environment as well as to rescue people and in some cases or jurisdictions also ...

paramedics A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...

, and other emergency personnel to search for the records of donor consent upon death. Another significant addition to the Uniform Anatomical Gift Act of 2006 is the rule of making transplantation or therapy prioritized over

research Research is "creativity, creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization and analysis of evidence to increase understanding of a topic, characterized by a particular att ...

or education with an anatomical gift when a donor's wishes are unclearly stated in documentation. The Uniform Anatomical Gift Act of 2006 clarifies words written in the law that formerly were ambiguous and confusing such as: anatomical gift, record, refusal, guardian, prospective donor, reasonably available, and disinterested witness. The UAGA revision of 2006 makes it a

felony A felony is traditionally considered a crime of high seriousness, whereas a misdemeanor is regarded as less serious. The term "felony" originated from English common law (from the French medieval word "félonie") to describe an offense that resu ...

punishable by a fine or prison to falsify, deface, or destroy organ donor documentation of another. Many states have drafted and enacted their own updated versions of the UAGA based on the revisions of 2006.

Legislation status of UAGA in the U.S.

In the United States, all states have enacted some version of the UAGA. States have the authority to use the Uniform Anatomical Gift Acts as a template to put additional revisions into law depending on what best fits the state's needs.

Ethical concerns

The UAGA does not specify regulations for organ donation by a prisoner or prohibit an inmate from donating their body or an organ.

Christian Longo Christian Michael Longo (born January 23, 1974) is a convicted murderer who killed his wife and three children in Oregon. Background Originating from Ypsilanti Township, Michigan, Longo married Mary Jane Baker at age 19 and had three children w ...

, a convicted

murder Murder is the unlawful killing of another human without justification (jurisprudence), justification or valid excuse (legal), excuse, especially the unlawful killing of another human with malice aforethought. ("The killing of another person wit ...

er, has played a key role in rousing public debate regarding the rights of the incarcerated to become organ donors. The retrieval of

gamete A gamete (; , ultimately ) is a haploid cell that fuses with another haploid cell during fertilization in organisms that reproduce sexually. Gametes are an organism's reproductive cells, also referred to as sex cells. In species that produce t ...

s from the deceased have been the subject of controversy because of the highly publicized court case '' In re Matter of Daniel Thomas Christy'' in Iowa, regarding the right to retrieve

reproductive cells A gamete (; , ultimately ) is a Ploidy#Haploid and monoploid, haploid cell that fuses with another haploid cell during fertilization in organisms that Sexual reproduction, reproduce sexually. Gametes are an organism's reproductive cells, also r ...

( posthumous sperm retrieval) from a deceased spouse or partner.{{Cite journal, last=Spielman, first=Bethany, year=2009, title=Pushing the dead into the next reproductive frontier: post mortem gamete retrieval under the uniform anatomical gift act, journal=Journal of Law, Medicine & Ethics, volume=37, issue=2, pages=331–343, doi=10.1111/j.1748-720X.2009.00376.x, pmid=19493077, s2cid=35736419 The argument against the retrieval of post mortem gametes in this case was that the UAGA stated the purposes of donation were for transplantation, therapy, research, or education. Since the Uniform Anatomical Gift Act was put into effect in all states, there still has been a donor shortage in the United States.

Case law

*'' Werling v. Sandy'' (Ohio 1985)

References

External links

Uniform Law Commission - Anatomical Gift Act (2006)OrganDonor.govThe Alliance - Organ Donation and Transplantation (UAGA)Association of Organ Procurement Organizations (AOPO)Gift of LifeDonate Life America: Organ Donor Registration
Organ donation Organ transplantation by country Anatomical gift