As your child heads off to college and into legal adulthood, they are likely thinking about class schedules, dorms, and meeting new friends, not estate planning. However, there’s one conversation that gets overlooked: what happens in the event of a medical emergency? Once your child turns 18, they are responsible for making their own medical decisions, including whether they wish to be an organ donor.
This blog will help parents and young adults understand the importance of documenting end-of-life preferences, explain what a living will does, and explore the debate surrounding organ donation.
What Is a Living Will?
A Living Will, also called an advance directive, is a legal document that outlines what kinds of medical care a person does or does not want if they are in a vegetative state or death is imminent. This may include instructions about life-sustaining treatment (like ventilators or feeding tubes) and organ donation preferences.
A living will is a simple but powerful way for a young adult to take control of their future medical care and ensure their voice is heard when they can’t speak for themself.
Organ Donation: What You Need to Know
Organ donation saves thousands of lives every year. One donor can save up to eight lives through organ donation and improve the lives of up to 75 people through tissue and cornea donations. Most people register as donors by checking a box on their driver’s license or enrolling in a state registry.
But the process is far more complex and sometimes controversial than many people realize.
The Controversy: Are Organ Donors Treated Differently?
There is an ongoing ethical debate about whether the interests of organ procurement organizations and transplant medicine can conflict with the goal of preserving life.
Concerns include:
Will Doctors Try as Hard to Save Me If I’m a Donor?
One of the most persistent fears is that doctors may not work as aggressively to save a registered organ donor if they believe that person’s organs could save others. While medical professionals are trained to prioritize saving lives, some critics argue that subconscious bias or institutional pressure could influence decisions when a patient is critically ill and organs are needed.
“There are real concerns about whether the declaration of brain death is always accurate or whether it may be rushed in order to facilitate organ harvesting,” says Dr. Robert Truog, professor of medical ethics at Harvard Medical School.
Is Brain Death Always Definitive?
Most organ donations occur after a patient is declared “brain dead.” But brain death testing protocols vary between hospitals. Additionally, not all hospitals use the most advanced testing such as cerebral blood flow studies to confirm the absence of brain activity.
In some cases, families have later questioned whether their loved one was truly deceased at the time of organ procurement. In rare cases, individuals declared brain dead have regained consciousness, further highlighting the concerns regarding the accuracy of brain death diagnoses.
Why Not Use Anesthetic?
Though brain-dead individuals are assumed not to feel pain, some doctors report seeing spikes in blood pressure or heart rate during organ removal, physiological responses that typically indicate stress. Dr. Truog has stated that, if it were his family member, he would request light anesthesia (such as fentanyl or sufentanil) during the procedure. These drugs don’t harm the organs but may provide peace of mind.
Can Families Negotiate or Set Conditions?
Some argue that not being listed as an organ donor on a driver’s license may provide more control. In this situation, the family is contacted to authorize donation and have used that moment to request more rigorous testing (like blood flow studies) or additional safeguards (like anesthetic use) before giving consent. While this is uncommon, your college student may want to consider this option if they are concerned about oversight in the organ donation process.
Action Steps for College Students
- Create a Living Will
Include clear instructions about life support, resuscitation, and organ donation preferences. - Designate a Healthcare Power of Attorney
Authorize a parent or trusted adult to make medical decisions if the student is incapacitated. - Have an Informed Conversation About Organ Donation
Consider both the life-saving benefits and the ethical questions. If your child wants to be a donor, they can still add conditions or request that decisions be left to family members. - Don’t Rely on Your Driver’s License Alone
Documenting organ donation wishes in a Living Will gives your child more control and allows space for nuance.
Final Thoughts
Organ donation is an incredible gift but it should never be a checkbox decision. As your child steps into adulthood, give them the tools to think critically and document their choices thoughtfully so their voice is heard.
Whether they choose to donate or not, its important that they have a clear, legally binding plan.
References
Nye, J. (2023) ‘AAN Panel Releases New Guideline For Brain Death In Adult and Pediatric Patients ’, https://www.neurologyadvisor.com/, 10 November. Available at: https://www.neurologyadvisor.com/features/aan-panel-releases-new-guideline-for-brain-death-in-adult-and-pediatric-patients/.
Greer, D. M., Wang, H. H., Robinson, J. D., Varelas, P. N., Henderson, G. V., & Wijdicks, E. F. M. (2015). Variability of brain death policies in the United States. JAMA Neurology, 73(2), 213. https://doi.org/10.1001/jamaneurol.2015.3943
