Democrat and Chronicle: ‘Presumed consent’ idea for organ donation stirs debate

ALBANY — A Westchester County assemblyman whose daughter is a two-time kidney transplant recipient wants to flip New York’s organ-donation system on its head by presuming people are donors unless they indicate otherwise.

“What we have in New York is a completely failed system,” said Assemblyman Richard Brodsky, D-Greenburgh.

Polls have found that the majority of New Yorkers would like to be donors, yet just 13 percent of residents 18 and older are on the state Donate Life Registry. More than 9,600 people in the state need organ transplants, according to the New York Organ Donor Network. Last year, there were just 423 deceased organ donors in New York.

“People are dying in New York this week because we have failed to create a system that maximizes the opportunities to keep them alive,” Brodsky said.

He said his bills to implement “presumed consent” have sparked a lot of interest. People approach him about it everywhere he goes, and individuals and religious groups have raised legitimate concerns. Because of that, he’s not pushing the proposal this session, he said.

“What I’ve said to anybody, whether they like it or they don’t like it, we can’t sustain the current system,” said Brodsky, whose daughter, Julianne Willie Brodsky, received her second transplant four years ago.

He is working on other reforms on organ donations, such as requiring the state Department of Motor Vehicles to provide information on organ donations and creating an organ donation tax credit.

Brodsky, a candidate for state attorney general, co-sponsored legislation this session that would let people consent to giving an anatomical gift through an electronic signature. It passed both houses and goes to Gov. David Paterson for his consideration. Forty-five states allow electronic signatures for donor registries, the New York Organ Donor Network said.

Other states with low donor-registration rates are Texas (an estimated 2 percent), South Carolina (9 percent) and New Hampshire (10 percent), compared to 73 percent in Alaska, an April Donate Life America report found.

No states have “presumed consent” laws, although there have been attempts in several of them, including Maryland and Pennsylvania. Legislation is under consideration in Illinois. A bill was introduced in the Delaware Legislature two years ago.

A number of European nations, including France, Austria and Spain, have this kind of system in place, and they have seen an increase in organ availability, said Arthur Caplan, a bioethics professor at the University of Pennsylvania School of Medicine.

Polls have found that the majority of New Yorkers and Americans want to donate organs and tissues when they die, so the burden should be on the minority to opt out, Caplan said. A recent survey by the New York Alliance for Donation found 67 percent of state residents strongly support organ and tissue donation.

The use of the term “presumed consent” can make some people angry because they don’t want presumptions made about what happens after they die, Caplan said. He prefers to call it “default to donation.”

To get traction in this country, “It’s going to take one state to sort of jump out there and show that it works,” said Caplan, who has been working on the issue since 1983.

Organ-donation groups report that common objections to presumed consent are a belief that physicians may not work as hard to save them and that the government and health care systems would have too much power.

The Long Island Coalition for Life Inc. opposes Brodsky’s legislation, which is sponsored in the Senate by Senate Health Committee Chairman Thomas Duane, D-Manhattan.

“This legislation opens up the door to abuse via hastened death of vulnerable people and overriding of family concerns,” Jerome Higgins, chairman of the coalition, wrote in a memorandum to lawmakers. “It also goes a step further toward turning human organs into commodities. The sick and disabled need to be protected, not exploited for their body parts.”

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