According to a recent news item, approximately 450 Nebraskans are waiting for an organ transplant on an average daily basis. Beginning next year, that number could begin to decline if legislation enacted this year fulfills its intended purpose.
Legislative Bill 1036 offered Nebraska’s lawmakers the essence of the latest version—2006 as updated—of the Revised Uniform Anatomical Gift Act (UAGA) promulgated by the National Conference of Commissioners on Uniform State Laws (NCCUSL). The bill’s intent and purpose are to update and improve governance and coordination of the donation and procurement processes, thereby facilitating more donations of body parts for transplantation, therapy, research and education.
Legislators gave LB 1035 a generally warm, but rather ho-hum reception. Its length (46 pages) and substance notwithstanding, the bill had a smooth, unchallenged trip through the legislative process, under the sponsorship of Senator Brenda Council of Omaha. It was introduced Jan. 21 and given final passage March 26, on a 48-0 vote. It was signed into law by the governor and takes effect next Jan. 1.
As its descriptive title suggests, LB 1036 is sort of model legislation. Its scope is limited to donations from deceased donors as a result of gifts made before or after their deaths. The basic framework and most of the details are the work-product of the NCCUSL, which creates and pushes for legislation that can be generally uniform and harmonized among all the states, on a variety of subjects. Like most states, Nebraska has several Uniform Law commissioners, typically highly influential attorneys. Two of these commissioners did most of the lobbying for LB 1036 and were bolstered in their efforts by the national chairman of the UAGA drafting committee, who visited the state and testified for the bill at the public hearing held by the Health and Human Services Committee.
The original Uniform Anatomical Gift Act was promulgated in 1968 and adopted by every state in a short period of time. In 1987, NCCUSL revised the 1968 UAGA to address changes in technology and practice. Only 26 states enacted that new version; Nebraska was not among them.
But Nebraska hasn’t ignored its anatomical-gift laws since 1968. There has been amendatory legislation several times during the intervening period; significant among such bills were establishment of an organ-donor registry, and a “first-person consent” law, which bars next-of-kin from overturning an adult’s own act of donation.
Before passage of LB 1036 in Nebraska, 38 other states had adopted the essence of the updated 2006 UAGA. While uniformity is the mantra, it hasn’t been achieved on an absolute basis. States have made independent decisions and changes within the framework, including Nebraska with LB 1036.
Among aspects of the UAGA adopted by LB 1036 is explicit recognition of the autonomous decision of anyone who desires not to be an organ donor. The legislation expressly allows for making a “refusal” to be a donor. If a refusal is written and signed, as with a document of gift, it has to be honored, assuming adequate communication.
There is a significant flaw in the way this autonomy is addressed. While there is an active registry and a process for effectuating a positive designation, no similar registry or process exists for the negative designation. It’s a general authorization; if one wants to use it, he or she has to make sure the decision is communicated in a variety of ways. Attempts to correct this flaw by opening the registry to refusals as well as donations were vigorously rejected by the uniform law commissioners, paying heed apparently to objections from the exclusive organ procurement organization in the state.
Catholic teaching encourages organ donation as an act of beneficence and charity, but there are moral principles and prescribed conditions to be upheld, such as informed consent, medical certainty that death has occurred and not causing death. As part of its response to enactment of LB 1036, the Nebraska Catholic Conference plans to provide information and guidance relating to this new law prior to its Jan. 1 effective date. Basic information on the bill is available on the Legislature’s website: www.nebraskalegislature.gov; enter LB 1036 and click on “Go.”
And finally… observations on a different matter:
Thursday, April 29 could not have been a great day for the Speaker of the Legislature, Senator Mike Flood of Norfolk, at least in terms of the morning’s headlines in the Midlands section of the Omaha World Herald. At the top of the page, there was this one: “Community colleges’ feud flares up.” Down a little on the same page was this one: “Second hospital in Kearney more likely—Talks break down between a doctor group and Good Samaritan.”
Senator Flood, you see, organized negotiation summits and appeared to have successfully brokered compromise agreements in both of those controversies. Those headlines indicated some cracks in those agreements; apparently minds didn’t stay met. Still, from the Speaker’s perspective, his efforts were good enough to keep both controversies from tying up the Legislature in its closing days.
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