Berks County Medical Society Medical Record Summer 2017 - 4

editor's comments

Too Many

PREVENTABLE DEATHS

W
Lucy J. Cairns, MD
Editor

hat explains the fact that, while 95% of Americans say they are in favor of organ
donation, only 54% have registered as donors? When applying for your driver's
license, it's as easy as checking the box. Online options include registering at
https://organdonor.gov or on the website or FaceBook page of Donate Life America, which
is a not-for-profit alliance of national organizations and 47 state-based organizations.
Although I had already registered in Pennsylvania when applying for my driver's license,
today I registered on the Donate Life America site to see how long it would take. It took 10
seconds.
Since the process of registering is quick and easy and can be done online, there must
be other explanations for the fact that almost half of eligible Americans are not registered.
Quite likely, some of the reasons are similar to those which explain why so many people
delay making a will and avoid other end-of-life planning steps, despite the obvious necessity
of taking such steps in order to have a say in one's medical care if incapacitated and in the
disposition of one's estate. Regarding wills, a Gallup poll conducted in 2016 two weeks after
the death of Prince - who apparently made no will despite his enormous assets - indicated
that only 44% of Americans had made a will. Just one in four Americans ever complete an
advance directive (Living Will and Durable Power of Attorney for health care decisions).
The reasons for these statistics are multiple and complex. Regarding both wills and
Advance Directives, younger adults are much less likely than older adults to have completed
the documents, so the perception of the likelihood of death striking in the foreseeable
future almost certainly plays a role. Although online services exist for creating wills and
Advance Directives, for those who prefer working with a lawyer in person, the process of
selecting a lawyer and the expense involved can be barriers. In a study published in 2014 in
the American Journal of Preventive Medicine1, the most common response selected by those
without an Advance Directive was "I don't know what advance directives are."
While there is no lack of knowledge about organ donation in general, misconceptions
about the details of the process and mistrust of medical personnel lead to more than a
few people deciding against donation. As Dr. Baxter points out in our lead article, fear
that doctors won't do everything possible to save the life of a donor is one common
misconception. In 2009 the New York Times reported on the results of a survey carried out
by Donate Life America which found that 44% of respondents believed there was a black
market for organs, and 57% were uncertain whether a person declared brain dead could
recover. Black markets for organs certainly exist in some countries, but no one being cared
for in a U.S. hospital should think their organs could end up being sold. The definition
of brain death is codified in the law of every state through adoption of the Uniform
Determination of Death Act after its promulgation in 1981:

1 Completion of Advance Directives Among U.S. Consumers
Rao, Jaya K. et al.
American Journal of Preventive Medicine, Volume 46, Issue 1, 65-70
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https://www.organdonor.gov http://berkscms.org/

Table of Contents for the Digital Edition of Berks County Medical Society Medical Record Summer 2017