DONATE LIFE ORGAN DONATION AWARENESS-UNITED STATES

Our view on end-of-life choices: States overlook easy way to raise organ donation rates

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OPPOSING VIEW: Adopt 'presumed consent'Heartwarming stories about desperate patients saved by donated organs are legion. Those left waiting without a medical miracle, though, seldom get attention — people like Sal Godoy, a father, grandfather and avid Little League coach from Oxnard, Calif., who waited eight years, hoping for a liver transplant. A match was never found. He died in 2008, a day after turning 56.

While more than 86 million Americans have enrolled to become donors, there are never enough hearts, lungs, kidneys, livers and pancreases for all those on waiting lists. Every year, more than 6,000 people share Godoy's fate, dying before donated organs could be located.

Those harsh facts are neither new nor surprising. What is surprising, though, is that many states seem blind to practices that are driving up organ donation rates elsewhere.

Last year, for example, more than 64% of driver's license and state ID applicants in Colorado signed up as donors, the best rate in the nation. Meanwhile, New York and Michigan couldn't hit a measly 13%.

The difference? In Colorado and seven other states with signup rates of more than 50%, motor vehicle department workers are required to ask applicants whether they want to sign up, according to Donate Life America, a non-profit advocacy group. In six states with some of the most abysmal rates, employees are not required to ask. In New York, for example, the question is merely on a form. In Michigan, it's even worse: Applicants have to volunteer that they want to be donors.

Prompting people to answer, especially verbally, is a powerful tool. Organ donation is an intimate subject, one people don't typically think about as they head for the DMV. Forms are easy to ignore. A little human interaction can go a long way toward promoting selflessness.

Other ways to increase donations can't be legislated. They depend on attitudes. Illinois' secretary of State, a longtime donor advocate, runs a $1 million-plus advertising campaign each year. In Louisiana, some DMV workers wear T-shirts to promote donations. Colorado has a special training program for DMV clerks.

In a handful of states, however, some well-intentioned advocates are pushing to exceed reasonable limits — so far unsuccessfully. Their idea, known as "presumed consent," would require that people be automatically added to state organ-donor registries unless they "opt out," perhaps when getting a driver's license or state ID.

Supporters of "opt out" point to its use in several European nations, including Austria, Belgium and Spain. But the very idea creates a backlash in the USA, which is one reason some donor groups oppose it. In California,Republican Gov. Arnold Schwarzenegger explored the presumed-consent idea but wisely decided to back the alternative requiring DMV employees to ask all applicants whether they want to donate. In New York and Illinois, legislation hasn't gotten much traction.

States shouldn't attempt to pressure citizens into donating organs. But they should be smart enough to adopt less intrusive practices that are working. Asking people a question at the DMV is no imposition at all, particularly if it means fewer Sal Godoys will die prematurely.