Donor groups, coroners at odds on bill
The last time Pennsylvania updated its organ recovery procedures, most people still had Blockbuster memberships.
In 1994, legislators enacted Act 102 mandating that Pennsylvania residents be educated and encouraged to become organ-and-tissue donors. Under the act, hospitals were required to notify organ-procurement organizations, such as the Center for Organ Recovery and Education and the Gift of Life Donor Program, about potential donors so that families could make the decision to donate.
More than two decades later, state legislators are looking to update Act 102 to bring it in line with acts passed by 47 other states. However, the Pennsylvania State Coroners Association is wary of its consequences.
Through HB 30 and its counterpart in the Senate, legislators look to make the process of turning over organs easier for organ-procurement organizations — hours matter when it comes to matching a donor with a recipient — but in a letter to the editor submitted by the Pennsylvania State Coroners Association, representatives say the legislation would drastically impact the ability to gather sufficient evidence after a homicide or wrongful death, especially in the case of drug deaths.
According to Donate Life Pennsylvania, a donation-funded initiative of the Gift of Life Donor Program, the Center for Organ Recovery and Education and the Pennsylvania departments of health and transportation, someone in the state dies every 18 hours waiting for an organ.
Pennsylvania leads the nation in the number of times coroners and medical examiners deny organ-procurement organizations from recovering organs after a death. According to Gift of Life attorney Stephen Tornone, Pennsylvania coroners have denied organ recovery 28 times since January 2014. Larger states denied procurement in less than a handful of cases.
Organ donation saves lives: Those four simple words are often touted as a key reason to tick off the proper box on a drivers license application. With that check mark, first responders and emergency personnel know what to do in the case of a person’s death.
Proponents, such as Keegan Gibson, a spokesman for Save a Life Now PA, say the act will help save lives. Full stop. Period.
“The Donate Life PA Act will create a statewide standard for Pennsylvania that matches national best practices,” Gibson said in an email. “The bill protects and respects the wishes of each donor or their family and protects criminal investigations at the same time. Coroners will still have unilateral authority to restrict donation as they do now, but they will be required to offer an explanation for this life-and-death decision.”
Save a Life Now PA is a campaign to expand education about organ donation and update Pennsylvania’s organ-donation laws. It has the support of thousands of concerned citizens and is a project of dozens of hospitals, trauma centers and nonprofits across the state, including the Center for Organ Recovery & Education and Gift of Life Donor Program.
Concerns: In outlining who is authorized or obligated to dispose of the body, including authorizing the body to be sent for organ donation, the bill gives equal weight to a coroner, medical examiner, warden, director of a correctional facility where a person was incarcerated, hospital administrator of the hospital where death was pronounced and “any other person authorized to dispose” of the body.
Another provision requires coroners or medical examiners to present themselves at the hospital where the organ recovery is set to take place. If there’s a reason they can’t make it, they are authorized to send a designee or visual authorization through a service such as Skype or Facetime.
On any given day, York County Coroner Pam Gay serves a county of more than 442,000 people with just a secretary and one of the off-site deputy coroners working alongside her. It’s a small, often overworked team that deals with deaths spread throughout the county.
“While we support organ donation and work with Gift of Life readily to allow for donation whenever possible, there are some instances when we’d like to have the coroner retain jurisdiction in deciding whether decedents should be reserved for death investigations,” she said. “That is what we trained for. That is what we owe our decedents and their families.”
Although Gay was once a transplant nurse and strongly believes in organ donation, she said, at the same time, she understands and supports the fear her fellow coroners have of losing potential evidence.
The other concern is the idea that she or a representative would have to present themselves to prevent someone from turning over their loved ones’ body for organ recovery before the conclusion of a death investigation or autopsy. It’s unsettling, she says.
“There’s concern that this bill could take that right away from them and give that to someone who has no relation to them. I think many people would not support the idea of someone unknown saying what could happen to their loved one.”
York County has denied no cases suggested for organ recovery since January 2014.
Disagreement: Coroners say they want more time when a death investigation is still needed — if the identity of the person is unknown and family needs to be notified, foul play, abuse or homicide is suspected or fault is unknown after a car accident.
Representatives of the coroners association say proponents of the denials cited in certain Pennsylvania counties make no mention of the overwhelming number of times organ recovery was able to take place. Overall, the association says, denials represent less than 1 percent of donations across the state.
However, organ-donation advocates say an estimated eight lives can be saved by each person willing to undergo organ recovery after death.
“When they say that’s a small number, that’s human lives,” Tornone said. “No matter how small the number may seem, it really matters to those people who are waiting for a transplant.”
HB 30 was scheduled for a vote earlier this week, but it was withdrawn. The state House will reconvene Oct. 17.