transplantIf you haven’t looked at your driver’s license in a while, you might want to take it out and flip it over. Do you have any of those little boxes ticked – the ones that grant permission for your organs to be harvested in the event of your death? Or have you registered elsewhere to be an organ donor? Organ donation is generally considered a good and noble commitment, but like any commitment, it bears serious consideration.

Lately there has been growing concern regarding organ donation following the publication of some articles, like this one from the Wall Street Journal, which suggest that patients who are “braindead” might, in spite of their condition, still be able to feel pain. According to the U.K. publication The Guardian, many medical experts argue for the anesthetization of potential organ donors because an editorial in the journal of the Royal College of Anaesthetists claimed that some patients from whom organs are being harvested exhibit possible signs of pain such as increased blood pressure and heart rate.

This can be a disturbing issue to consider, given that we usually think of death as a black-and-white matter, and that people who are dead cannot, by definition, feel pain. However, modern medical technology has blurred the lines between life and death. Now there are different types of death, and only one type results in potential vital organ donors. That type is “braindeath,” wherein only the brain ceases to function properly, and the other vital organs (heart, lungs, pancreas, kidneys, and liver) continue to operate and keep the body alive. This condition allows surgeons to harvest still-living vital organs and to keep those organs alive long enough to transplant. On the other hand, patients who have “flat-lined,” who have no heartbeat, are not eligible to be vital organ donors because their organ tissue is no longer living. For some would-be donors, this grisly discussion of different types of death and the use of jarring but unavoidable medical terms like “braindead” can be off-putting. It also raises questions about whether being “braindead” is really the same thing as being “dead” and whether or not it is possible to recover from a state of braindeath.

Donation advocacy groups such as Donate Life strive to relieve public concerns about organ donation. A common misconception is that doctors in hospitals provide subpar medical treatment for potential donors or may prematurely declare a patient braindead because they are more interested in harvesting and selling the organs than treating the patient. But the transplant system simply doesn’t work that way, according to these advocacy groups, and hospitals and surgeons do not receive a direct monetary benefit for the organs they harvest. According to their website, the first priority of doctors is always to save the patient’s life.

Now, far be it for me to discourage anyone from making a potentially life-saving donation. On the contrary, I’m in favor of organ donation. But here’s the deal: you should know what you’re getting into before you register for anything, including being an organ donor. Talk to your health care provider and a legal professional about what donor registration means for your rights and your treatment after braindeath. If you do register in advance as a donor, you may not be guaranteed to receive anesthetic before your organs are harvested, and your Health Care Agent may lose the ability to control how your body is treated after you are declared braindead. These are issues you should understand before registering. In the East Tennessee area you can contact Tennessee Donor Services at (865) 588-1031. Other resources that may be helpful include the American Association of Tissue Banks, the Eye Bank Association of America, and the US Department of Health & Human Services.

Here’s a smart alternative: authorize your Health Care Agent to make decisions about organ donation through your Durable Health Care Power of Attorney. Be sure your Agent understands your wishes and is a good advocate. Provide that the Agent has discretion to donate organs under circumstances including a requirement of anesthesia. By understanding the ins and outs of the donation process and tailoring your documents accordingly, you can still make a life-saving contribution while ensuring that your body is treated exactly how you want it to be treated, even after your death.