Organ donation is a legally binding decision if the potential donor is 18 years or older and has registered as a donor through an advanced medical directive, donor registry, or organ donor card. However, recent Arkansas legislation now allows family members to amend or revoke an organ donation.
April is recognized as Donate Life Month, honoring organ donors and transplant recipients on waiting lists. Life-saving organ donations from deceased donors have increased over the past 12 years, with over 15,000 donated organs in 2024. Although 90% of Americans support organ and tissue donations, only 60-65% of potential donors have signed up on a donor registry.
Uniform Anatomical Gift Act
Donation decision-making is legally binding under the Uniform Anatomical Gift Act (UAGA), which many states have adopted. Family members do not have the legal authority to revoke a donor’s wish. Called "First Person Authorization," an organ donor may indicate their donation decision by a driver’s license designation, organ donor card, or other legally binding document, even if there are family objections.
Organ Donation Process
This donation process is called “opt-in,” in which a living donor must expressly show their intent to donate organs or tissue. This opt-in is the rule in the United States. Other countries, such as Austria and Spain, have a presumed consent organ donation process whereby a deceased person is considered an organ or tissue donor unless they have expressly stated their intention to “opt out.”
Organ Procurement Organizations (OPOs) that handle the organ recovery for future organ transplants must follow the directives of the organ donor. Healthcare professionals generally advise donor families of the decision-makers’ gift of life, but they do not go against advance medical directives.
However, some states allow family members to dispute donations if they were made without informed consent (such as lacking mental capacity) or under duress. Many states allow legal next of kin to decide to donate their family member’s organs as long as the family member did not expressly opt out of organ donation.
New Legislation May Affect Organ Donation Decisions
In April 2025, the Arkansas legislature passed an amendment to the Revised Arkansas Anatomical Gift Act, adding a provision in which next of kin can prevent their loved ones’ organs from being harvested for donation, even if their loved one was a registered donor.
The act now allows that if a donor is incapacitated, their deceased donation may be modified, amended, or revoked by the following:
- The donor’s healthcare agent
- The donor’s spouse
- The donor’s adult children or adult grandchildren
- The donor’s parents, adult siblings
- The donor’s guardian
- A person who is a special caretaker of the donor
- A person who has the authority to dispose of the donor’s body.
If you have a strong wish to be an organ donor, make sure you register with your state’s organ donor registry. Often, you can do this at your Department of Motor Vehicles (DMV). You can also put your wishes in a living will or healthcare directive.
You should also discuss your wishes (or put them in writing) to alert your loved ones of your decision and reasoning behind it. If your family understands your wishes, they may be more inclined to honor them.
Related Resources
- Create Your Own Estate Planning Documents (DIY Estate Planning Forms)
- Living Will and Healthcare Directives (FindLaw Learn About the Law)
- Best Estate Planning Lawyers Near Me (FindLaw Attorney Directory)
