Towards greater gun safety in San Jose

 The mayor of San Jose, CA, has some thoughts on making guns and gun ownership less dangerous, in a  NY Times opinion column:

400 Million Guns Aren’t Going to Just Go Away. In San Jose, We’re Trying Something New. By Sam Liccardo (Mr. Liccardo, a Democrat, has been the mayor of San Jose, Calif., since 2015. He is a former federal and local prosecutor.)

"Amid the rising tide of firearms, reducing gun deaths and injuries requires new solutions. In San Jose, Calif., where I am mayor, we’ve embarked on two approaches untried in any other city or state: We’re imposing an annual fee on gun-owning residents and investing the revenues in violence prevention efforts. And on Jan. 1, the city will begin requiring gun owners to carry liability insurance to compensate victims harmed by the negligent or reckless use of a firearm.

...

"Most gun-owning residents can comply with the insurance mandate with little or no additional cost under standard homeowners’ and renters’ policies. As more jurisdictions adopt an insurance requirement — legislators in New Jersey and California have recently proposed them — we expect that the insurance industry will become increasingly invested in reducing gun-related harm. Premiums will reflect the risks of gun ownership and will adjust accordingly, in the same way that auto insurers offer “good driver” discounts or how they incentivized the installation of anti-lock brakes and airbags in the past.

"Of course, in the realm of gun regulation, no good deed goes unlitigated. Three groups sued San Jose after the ordinance imposing the fee and insurance requirement passed. A Federal District Court declined their pleas for an injunction to stop the ordinance from taking effect, finding no unconstitutional burden on Second Amendment rights where “there are no means by which a San Jose gun owner may be deprived of his or her firearm.”

Opt out organ donation in England and the Netherlands

 

Jansen, N. E., Williment, C., Haase-Kromwijk, B. J. J. M., & Gardiner, D. (2022). Changing to an Opt Out System for Organ Donation—Reflections From England and Netherlands. Transplant International, 133.

Abstract: Recently England and Netherlands have changed their consent system from Opt In to Opt Out. The reflections shared in this paper give insight and may be helpful for other nation considering likewise. Strong support in England for the change in legislation led to Opt Out being introduced without requiring a vote in parliament in 2019. In Netherlands the bill passed by the smallest possible majority in 2018. Both countries implemented a public campaign to raise awareness. In England registration on the Donor Register is voluntary. Registration was required in Netherlands for all residents 18 years and older. For those not already on the register, letters were sent by the Dutch Government to ask individuals to register. If people did not respond they would be legally registered as having “no objection.” After implementation of Opt Out in England 42.3% is registered Opt In, 3.6% Opt Out, and 54.1% has no registration. In contrast in Netherlands the whole population is registered with 45% Opt In, 31% Opt Out and 24% “No Objection.” It is too soon to draw conclusions about the impact on the consent rate and number of resulting organ donors. However, the first signs are positive."

...

"There had been many failed attempts to introduce Opt Out legislation to England over the last 30 years but was achieved on 20th May 2020. In October 2017 the Prime Minister stated her intention to shift “the balance of presumption in favour of organ donation” and “introduce an opt out system for donation.”

"Fortuitously a parliamentarian from the opposition party had successfully had his name drawn from a legislation ballot (a system which allows a few “Private Members Bills” to be considered by parliament from a randomly chosen subset of legislation suggestions), for a new Opt Out Bill. This led to an unusual alignment of opposing political parties, working together on a new policy. Due to this cross party support, the Bill progressed through Parliament and never had to be put to a vote.

"England’s Opt Out legislation built on the positive experience in Wales and Parliament was further reassured by the response to a public consultation on the draft Bill, which asked how Opt Out should be introduced. The Government usually expects between 200 and 500 responses; over 17,000 responses were received. The responses were supportive and gave a strong steer for the issues needing to be addressed.

"The main issues raised by the public were: the need for autonomy and individual choice; the role of the family; the need to respect faith and beliefs through the donation process. The government worked closely with NHSBT to identify ways to ensure that these issues were addressed. Ministerial commitments also secured additional resources such as increased recurrent funding.

"The final inspiration came from two young people—Max Johnson and Keira Ball. When the Bill was introduced, Max Johnson, a 9 year old boy, was in desperate need of a heart transplant. The UK media—particularly the Mirror newspaper—campaigned for the introduction of Opt Out legislation. Max’s life was saved through the gift of donation by Keira Ball, also aged nine, who tragically lost her life in a road traffic collision. The Opt Out legislation is known as Max and Keira’s Law, in their honour.

"Netherlands

"On the 1st of July 2020 the Opt Out system for organ donation was implemented in Netherlands. Changing the organ donation law from an Opt In consent system into an Opt Out system had not been easy. It took more than 12 years of political discussion to reach the milestone of a majority.

"In 2012 a member of the House of Representatives prepared a Bill to change the consent system into an “Active Donor Registration.” On the 16th of September 2016 the Bill was passed by the smallest possible majority in the House of Representatives, 75 members voted in favour of the Bill and 74 members against. On the 16th of February 2018 the vote in the Senate again ended in a close call, 38 senators voted in favour of the Bill and 36 members against. The Bill could only pass after a required amendment to develop a “Quality Standard Donation,” which describes the role of the doctor and the family in the donation conversation, based on the different outcomes of the Donor Register.

"The Active Donor Registration means that Dutch residents without a registration in the Donor Register, 7 million, will be asked by letter to register their donation preferences (same options as in the Opt In system). If they do not respond to a first and second letter, they will receive a third and final letter with the confirmation that they will be registered as having “No Objection” to organ and tissue donation. Under the new legislation “No Objection” would legally be considered the same as a registration of “Yes, I want to be an organ donor.” Registrations can be changed 24 h a day via the Internet. It could therefore be argued that while the change in law was to introduce Opt Out, it has similarities to a model of mandated choice for organ and tissue donation (6).

Pregnancy in Poland, a database and anti-abortion laws

 The Lancet recently reported on new pregnancy data being collected in Poland, and controversy on whether and how it might be used in enforcing Poland's very stringent anti-abortion laws.

Poland to introduce controversial pregnancy register, by Ed Holt, Lancet,  VOLUME 399, ISSUE 10343, P2256, JUNE 18, 2022  DOI:https://doi.org/10.1016/S0140-6736(22)01097-2

"A new legal provision in Poland requiring doctors to collect records on all pregnancies has been condemned by critics who fear it could create a pregnancy register to monitor whether women give birth, or track those who go abroad for abortions.

Poland has some of Europe's strictest abortion laws, with terminations allowed in only two instances—if the woman's health or life is at risk and if the pregnancy is the result of either rape or incest. Until last year, abortions had also been allowed when the fetus had congenital defects. Most legal terminations in Poland were carried out under this exemption. But this provision was removed by a constitutional court ruling following a challenge by members of the ruling right-wing Law and Justice party, which some rights activists accuse of systematic suppression of women's rights.

Rights groups and opposition Members of Parliament (MPs) say that, in light of the tightened abortion legislation, they worry that the collected pregnancy data could be used by police and prosecutors in an unprecedented state surveillance campaign against women. “A pregnancy register in a country with an almost complete ban on abortion is terrifying”, Agnieszka Dziemianowicz-BĄk, an MP for the New Left party, said. 

***********

Here's a recent NY Times story on the implementation of Polish anti-abortion law:

Poland Shows the Risks for Women When Abortion Is Banned. Poland’s abortion ban has had many unintended consequences. One is that doctors are sometimes afraid to remove fetuses or administer cancer treatment to save women’s lives.  By Katrin Bennhold and Monika Pronczuk, Updated June 16, 2022

"Today, Poland and Malta, both staunchly Catholic, are the only European Union countries where abortions are effectively outlawed.

"The consequences in Poland have been far-reaching: Abortion-rights activists have been threatened with prison for handing out abortion pills. The number of Polish women traveling abroad to get abortions, already in the thousands, has swelled further. A black market of abortion pills — some fake and many overpriced — is thriving.

"Technically, the law still allows abortions if there is a serious risk to a woman’s health and life. But critics say it fails to provide necessary clarity, paralyzing doctors."

Family consent and opt-in versus opt-out organ donation

Here's a contribution to the discussion on how opt-out versus opt-in deceased donor laws might impact transplantation (as opposed to just registration) in countries in which family consent is needed before a deceased person's organs are donated.

J Exp Psychol Appl. 2018 Aug 16. doi: 10.1037/xap0000183. [Epub ahead of print]

Underlying wishes and nudged choices.

Lin Y1, Osman M1, Harris AJL2, Read D3.

Abstract

Is the inferred preference of a deceased relative to donate his or her organs stronger when the choice was made under a mandated rather than under an automatic default (i.e., nudged choice) legislative system? The answer to this is particularly important, because families can, and do, veto the choices of their deceased relatives. In three studies, we asked American and European participants from countries that have either a default opt-in or a default opt-out system to take on the role of a third party to judge the likelihood that an individual's "true wish" was to actually donate his or her organs, given that the decedent was registered to donate on the organ donation register. In each study participants were randomly assigned to one of four organ donation legislative systems (default opt-in, default opt-out, mandated choice, mandatory). Overall, regardless of which country participants came from, they perceived the donor's underlying preference to donate as stronger under the default opt-in and mandated choice systems as compared with the default opt-out and mandatory donor systems. We discuss the practical issues that result from using default systems in the domain of organ donation and propose potential ways to ameliorate the uncertainty around inferences of underlying preference from a nudged choice. 

*****************
HT Axel Ockenfels

Related earlier posts:

Don't take "No" for an answer: a reconsideration of how to do deceased donor registration

Wales' organ donation opt-out law has not increased donors--BBC

Presumed consent: too early to declare failure, but cautions are plentiful

Frank McCormick points out a recent report in the journal Health Policy indicating that the Welsh move from opt-in to opt-out or ('deemed consent') for deceased organ donation has not so far been successful at raising transplant rates:

Welsh 2013 deemed consent legislation falls short of expectations
by Jordan Alexander Parsons

"Abstract: Wales, in 2013, was the first country in the United Kingdom to pass legislation introducing presumed (or deemed) consent for organ donation, and remains the only one. It was introduced in an attempt to increase the number of life-saving transplants taking place in the UK, in a move that policy makers hoped would mirror Spain’s success. More recently, pressure has been mounting for England to follow suit, with a public consultation currently in progress. However, the Welsh system has been far from a success, raising the question of why campaigners are so adamant that it should be replicated. Before the Welsh Government introduced the Human Transplantation (Wales) Act there had been no strong evidence to suggest it would make a difference, with countries boasting both high organ donation rates and presumed consent legislation demonstrating no clear causal relationship between the two facts. In addition, a recent report evaluating the Act has highlighted its failure to improve donation rates, and has even presented some potentially concerning statistics that may suggest a negative impact. This paper first considers presumed consent in other countries – Spain and Brazil – before illustrating the underwhelming progression of Wales’ new system and the need to look to other options."

Here's a paragraph that strikes me as important, because family consent is important in Wales, and automatic inclusion on the deceased donor registry reduces the signal value that the deceased wished to be a donor:

"Under the Welsh system, the deceased is deemed to have consented to donation unless (1) a decision as to donation by the deceased is in force, (2) the deceased had appointed a person or persons to make the decision on their behalf, or (3) a relative of friend of long standing objects on the basis of views held by the deceased and it is reasonable to assume the objection is accurate [2]. It is down to the medical team to determine whether a relative’s objection is their own, or one based on the views of the deceased. Unsurprisingly, doctors have not shown willing to challenge these objections, despite their legal right to; they consider it inappropriate to go against the wishes of the family."
**************

Here is a related article, which raises other potential problems:
Presumed consent will not automatically lead to increased organ donation
Sharif, Adnan
Kidney International , Volume 94 , Issue 2 , 249 - 251

"a review of the latest available data (2016) from the Global Observatory on Donation and Transplantation suggests no significant difference in overall transplantation activity between presumed versus explicit consent countries, with increased deceased organ donor rates balanced by decreased living donor rates among presumed consent countries (Table 1). Whether the consent process is presumed or explicit has no bearing on many inter-related factors that influence organ donation rates. For example, Coppen et al.4 observed a strong correlation between mortality rates and organ donation numbers (Spearman’s r = 0.81, P < 0.01) and that, after controlling for differences in relevant mortality rates, there was no significant influence of presumed versus explicit consent on organ donation rates."

Table 1 Organ donation and transplantation activity

Parameter	Presumed consent (mean ± SD per million population)	Explicit consent (mean ± SD per million population)	P value
Kidney (deceased)	30.9 ± 15.1	22.6 ± 11.1	0.078
Kidney (living)	4.8 ± 2.6	16.9 ± 8.4	<0 .001="" td="">
Liver (deceased)	12.9 ± 8.5	10.1 ± 5.3	0.265
Liver (living)	0.4 ± 0.9	2.7 ± 5.3	0.107
Heart	4.8 ± 3.5	3.1 ± 2.6	0.108
Lung	3.5 ± 4.0	4.2 ± 2.8	0.543
Pancreas	1.6 ± 1.6	1.4 ± 1.0	0.579
Overall transplant activity	59.1 ± 30.7	58.9 ± 23.4	0.982

From the Global Observatory of Donation and Transplantation registry ( www.transplant-observatory.org).
...
"The other concern with presumed consent is the reduced rate of living donation observed in presumed consent countries, a phenomenon repeatedly observed in systematic reviews and apparent in current registry data (Table 1). Many will argue that an increased supply of deceased organ donors with presumed consent overrides the need for living donors. However, it is unlikely switching to presumed consent can ever completely eradicate organ waiting lists, and living donation facilitates transplantation for many high-risk (predominantly kidney) recipients who would otherwise be deemed unsuitable for the transplantation procedure. Altruistic living kidney donors are a valuable resource to facilitate kidney transplantation for some of the most immunologically difficult and long-waiting end-stage kidney failure patients,7 and the risk of these numbers declining, although purely speculative in the setting of a switch to presumed consent, would jeopardize successful national living kidney sharing schemes. Declining living donation rates could therefore be further hampered by switching to presumed consent, with adverse consequences for established kidney transplantation programs."

Old enough to drive, old enough to register to donate in Illinois

Here's the press release
Illinois Senate Unanimously Passes Legislation to Strengthen Organ Donor Registry
The "Drive for Life" Bill Would Allow 16- and 17-Year-Olds to Join State Registry

"SPRINGFIELD, Ill., May 16, 2017 /PRNewswire-USNewswire/ -- In an overwhelming bipartisan show of support, the Illinois State Senate unanimously passed (53-0) HB 1805, the "Drive for Life Bill".  Supported by the Secretary of State, a coalition of state legislators and Gift of Hope Organ and Tissue Donor Network and Mid-America Transplant, this critical legislation amends Section 6-117 of the Illinois Vehicle Code to allow Illinois residents 16 and older to join the organ donor registry. The bill will now be presented to Illinois Governor Bruce Rauner to sign into law.
...
"Illinois is one of only three states in the union that does not allow 16- and 17-year-olds to register their wishes to become organ donors. The "Drive for Life Act" would ensure all residents 16 and older may choose to officially join the First-Person Authorization Registry. While the law gives 16- and 17-year-olds the right to express their wishes, parents and legal guardians will maintain the right to give or revoke consent until the registered donors turn 18-years-old."

You can register as an organ donor in MN when you get a fishing license

Organ donation isn't just for drivers' licenses in Minnesota:
Fish, hunt, save lives: MN first to offer organ donor option on fishing license

"Organ donation through the Department of Natural Resources license registration website went live March 1, and already 4,300 people have checked the donor box. It’s only available online, not in stores, and works the same as the organ donation option on a driver’s license."

Organizing organ donation by social media

In the NY Times, David Bornstein writes about the efforts by Organize to bolster organ donor registries by prompting statements of intent on internet media:
Using Tweets and Posts to Speed Up Organ Donation

"One group attacking the question is Organize, which was founded in 2014 by Rick Segal’s son Greg, and Jenna Arnold, a media producer and educator who has worked with MTV and the United Nations in engaging audiences in social issues. Organize uses technology, open data and insights from behavioral economics to simplify becoming an organ donor.

This approach is shaking up longstanding assumptions.

For example, in the last four decades, people have most often been asked to register as an organ donor as part of renewing or obtaining a driver’s license. This made sense in the 1970s, when the nation’s organ procurement system was being set up, says Blair Sadler, the former president and chief executive of Rady Children’s Hospital in San Diego. He helped draft the Uniform Anatomical Gift Act in 1967, which established a national legal framework for organ donation. “Health care leaders were asking, ‘How do we make this more routine?’” he recalled. “It’s hard to get people to put it in their wills. Oh, there’s a place where people have to go every five years” — their state Department of Motor Vehicles.

Today, governments allow individuals to initiate registrations online, but the process can be cumbersome. For example, New York State required me to fill out a digital form on my computer, then print it out and mail it to Albany. Donate Life America, by contrast, allows individuals to register online as an organ donor just by logging in with email or a Facebook or Google account — much easier.

In practice, legal registration may be overemphasized. It may be just as important to simply make your wishes known to your loved ones. When people tell relatives, “If something happens to me, I want to be an organ donor,” families almost always respect their wishes. This is particularly important for minors, who cannot legally register as donors.

Using that insight, Organize is making it easier to conduct social media campaigns to both prompt and collect sentiments about organ donation from Facebook, Twitter and Instagram.

If you post or tweet about organ donation, or include a hashtag like #iwanttobeanorgandonor, #organdonor, #donatemyparts, or any of a number of other relevant terms, Organize captures the information and logs it in a registry. In a year, it has gathered the names of nearly 600,000 people who declare support for organ donation. Now the big question is: Will it actually increase organ donation rates?

We should begin getting an idea pretty soon. Organize has been working with the Nevada Donor Network to test its registry. And in the coming months, several other states will begin using it."

To help Paris, donate blood... later (guest post by Carmen Wang)

Carmen Wang writes:

To help Paris, donate blood... later.

Paris needs blood donations in the aftermath of the Attacks, although not that much more than a typical Saturday (EFS press release). Real shortages, however, are very likely in the upcoming winter and holiday season. Market designers point out that blood donations, with kind intention, can happen at wrong times. Instead, would-be donors can register their names and availability with the blood service, and help later when blood is most needed.

Paris:
Long queues to donate blood everywhere 

EFS (French Blood Service) informing of enough blood supply and asking donors to come back later

Boston in 2013:
Various calls for blood donations after the Boston Marathon Bombing, for example

(Notice the time of this tweet and that of the next tweet)

The American Red Cross politely declining more blood donations

What happened in the two cities are not coincidences.

Similar phenomenon in blood donations has happened during so many disasters like 9/11, Hurricane Katrina, Victoria Bushfire in Australia. In severe cases, it leads to blood, the gift of life, being left expired on the shelf. However, in 'normal' times most countries suffer recurring blood shortages, especially during winter, due to the holiday season and that many regular donors are affected by cold and flu. Particularly this time in Paris, the winter is coming. The blood collected today will expire in a few weeks right at beginning of the winter months. Moreover, donors who donated today, when there is no real blood shortage, will not be able to donate in winter when shortages do occur. We can only donate blood approximately once every 3 months. Blood is so precious, so donate wisely.

The reason why the above phenomenon repeats itself across the world is because blood donations need to follow the demand for blood, but most people do not have the necessary information. In addition, other people's donations also affects the supply of blood in real time, which makes it impossible for an individual donor to decide whether it is a good time to donate blood. In Paris, we do want to help those who are injured in the Attacks, but not all donors need to respond at the same time. Too many donations can quickly lead to wasteful congestion and oversupply, and worse, potentially affect the blood supply immediately afterwards.

The solution is surprisingly simple, which is to set up a blood donation registry. People who want to help now can sign up in a registry, and commit to donate later when a blood shortage does occur. After all, a need for blood anytime is a need for blood. What difference does it make if it occurs during the Paris Attacks, Boston Marathon Bombing, Australia's Victoria Bushfire versus other 'ordinary' times? The blood service, which knows the need for blood at any given time, can contact donors in the registry to meet any excess demand for blood, and maintain an adequate level of blood supply in the long term. With the help of the registry, registered donors can be informed correctly not only when there is a potential shortage in aggregate, but more importantly, when their donations are needed and when others have donated enough. 

So to people in Paris, how about a registry in memory of Paris Attacks? The registry not only helps smooth out supply in disaster times, but also helps donors to stay informed, and donate whenever there is a need in normal times. And to donors anywhere in the world, the need for blood in your local area might be more than that in Paris as today. If you would've helped were you in Paris, maybe someone needs your help right now right around you.

More details, see paperSlonim, Robert, Carmen Wang, and Ellen Garbarino (2014). The Market for Blood. The Journal of Economic Perspectives, 28(2), 177-196.
And two upcoming working papers (inquire authors for more information)Slonim, Robert and Carmen Wang (2015), Market design for altruistic supply: Evidence from the Lab

Garbarino, Ellen, Stephanie Heger, Robert Slonim and Carmen Wang, Redesigning markets for blood donations: A blood donation registry

Organ donors increase in California, as undocumented residents become eligible for driver's licenses

Organ donors increase in California

"BAKERSFIELD, Calif. (KBAK/KBFX) - There has been a recent hike in people registering as organ donors in California.

"Reports show that the increase just might be linked to AB 60, the new law helping undocumented residents obtain driver's licenses. More than 60,000 people have been added to the California organ and tissue donor registry, bringing it up 29 percent from the same time last year.

"Lori Malkin is the founder of JJ's Legacy, a local nonprofit group aimed at educating the community about the importance of becoming an organ donor.

"If you are registered donor, you can save and heal lives through organ, eye, and tissue donations," said Malkin.

She launched JJ's Legacy in honor of her son, Jeffery Johns.

"I am a donor mother. My son was killed in an automobile accident and died from a head injury," said Malkin. "He had the opportunity to donate all of his organs and his corneas and tissue. He enhanced and saved eight lives through organ donation, and he also enhanced and saved 58 lives through tissue and cornea donation."

Don't take "No" for an answer: a reconsideration of how to do deceased donor registration

Don't Take 'No' For An Answer: An Experiment With Actual Organ Donor Registrations

Judd B. Kessler, Alvin E. Roth

NBER Working Paper No. 20378
Issued in August 2014
NBER Program(s):   HC 

Over 10,000 people in the U.S. die each year while waiting for an organ. Attempts to increase organ transplantation have focused on changing the registration question from an opt-in frame to an active choice frame. We analyze this change in California and show it decreased registration rates. Similarly, a "field in the lab" experiment run on actual organ donor registration decisions finds no increase in registrations resulting from an active choice frame. In addition, individuals are more likely to support donating the organs of a deceased who did not opt-in than one who said "no" in an active choice frame.

The paper has attracted a small bit of more or less accurate press and blog attention, which is good for a paper that attempts to shed light on what may be a mistaken public policy initiative. Here's a sample.

One way to boost organ donations: Just keep asking

Don’t Take No For an Answer: Lessons From Organ Donation

In The Papers: Skills Gap, Organ Donation And Parental Politics

Ask often to get more organ donors

Organ donor registration in Israel

Judd Kessler and I just got this email from Jacob Lavee (about whom I've written before), with good news that he kindly gave me permission to post:

Dear Al and Judd,

Just a short note to let you know that the Israeli Minister of Health has adopted this week my recommendation to establish by law the modified mandated choice model based upon your work, whereby the issuing or renewal of an ID, passport or driving license will be conditional upon answering the question of becoming a registered donor to which only a positive answer will be given as an option or else the “Continue” button will be selected. It seems that, contrary to my previous worries, the entire registration for these documents is currently being done online and therefore there should be no technical issues to implement this model.

Thank you guys for providing the proof of concept which I cited to the ministerial committee.

This model will be added upon the prioritization model, which is already implemented by law.

Jay
*******************

The work Jay is referring to is a paper, currently out for review at a journal that doesn't like prepublication on the web, "Don’t Take ‘No’ For An Answer: An experiment with actual organ donor registrations," which finds, in a study of the online MA state organ donor registry, that requiring potential donors to choose either "yes" or "no" when asked if they wish to be on the donor registry does not increase registrations, and seems likely to reduce the rate of donations by next of kin when the deceased is unregistered.

Deceased donor registration versus transplantation in Malaysia

The National News Agency of Malaysia (BERNAMA) has the following disheartening report on the difference between deceased organ donor registration and subsequent transplantation:

Sarawak News

---

November 16, 2013 19:10 PM

Organ Transfer Conducted From Only 435 Of 237,395 Registered Organ Donors - Lee Lam Thye

SIBU, 16 Nov (Bernama)- The Organ Donation Public Awareness Action Committee revealed that only 435 of the 237,395 registered organ donors had donated their organs after their death so far.

Its chairman, Tan Sri Lee Lam Thye, said the number was very small compared with the number of those who had registered to donate their organs upon their death.

He attributed this to, among others, the family members or next-of kin of the registered organ donors not allowing the organ transfer to be conducted when the former died.

"This happens because the registered donors did not inform their family members of their pledge to donate their organs upon their death.

"Hence, we advised those who have pledged to donate their organs upon their death to inform their family members of their decision," he told a media conference after an organ donation campaign here Saturday.

Organ donation registration on college applications, in India

Here's the story: Governor tells V-Cs to offer option for organ donation in college admission forms

"In a meeting held recently, the governor had urged the V-Cs to offer a separate column in the college admission forms for organ donation. T C Benjamin, Additional Chief Secretary (public health) said filling the column is not mandatory and students will have the choice. The state had made it a must for hospitals to inform the organ transplant centres about brain-dead patients. "

Bone marrow registries

The NY Times reports on an effort to start a bone marrow registry in Nigeria, and to increase donation among African Americans: Finding a Match, and a Mission: Helping Blacks Survive Cancer

"Now he is trying to repay that debt, with an effort that experts say may save the lives of both Nigerians and black Americans. In February, he helped start Nigeria’s national bone-marrow registry, the first in Africa outside South Africa. He is now raising money to start a cord-blood bank there.

Millions of Nigerians have blood cancers like leukemia or lymphoma, and about 4,000 black Americans die annually of them. Less than 20 percent of black Americans now find the perfect donor matches that could save their lives, while more than 70 percent of whites do. Without a registry and cord-blood bank, no Nigerians do.

“This is a slam-dunk, from my point of view,” Mr. Adebiyi said. “The U.S. registries are trying to figure out how to increase the population of minority donors; this is a solution they should be interested in.”

Becoming a donor is relatively simple nowadays; only a cheek swab is needed to test for a match. Donating rarely requires the painful hip punctures that used to be routine. Instead, an intravenous blood line runs through a cell separator after the donor takes drugs to push the stem cells into the bloodstream. The process is no more burdensome than dialysis, experts say.

But for African-Americans like Mr. Adebiyi, finding matches is particularly difficult. Blacks are less likely to register as donors; while blacks are 12.6 percent of the population, only 8 percent of registered donors are black.

“It’s lack of education about it, and mistrust of the medical system after scandals like Tuskegee,” said Shauna Melius, co-founder of Preserve Our Legacy, citing the Tuskegee, Ala., experiment in which government doctors recruited black farmers for research and let those with syphilis go untreated for decades. Her organization recruits donors at Harlem Hospital and through drives featuring black celebrities.

“Plus,” she added, “people are skeptical because you’re collecting DNA.”

Complicating the problem, blacks are more genetically diverse than whites. Anatomically modern Homo sapiens existed in Africa for 200,000 years before migrating north to Europe a little over 40,000 years ago, so all Europeans descend from the shallower end of the gene pool.

Organ donation registration on income tax forms

Organ donation checkoff proposed for tax forms

"LANSING, Mich. - Michigan's secretary of state wants to make organ donation easier by adding a checkoff box on annual tax forms.
Terri Lynn Land says the box would be similar to the current section of the tax form that asks filers if they want part of their taxes to go to the State Campaign Fund.
Tax filers would have the option of marking the box which allows their names to be added to Michigan's Organ Donor Registry.
Land says the proposal allows for a convenient way for organ donors to sign up and allows every Michigan taxpayer to be reached "at virtually no cost" during current lean fiscal times. Her proposal has to go before the state Legislature."

HT Steve Leider

Organ donor registry mishap in Britain

The Telegraph reports: Organs removed without consent after IT blunder

"The records of 800,000 people were affected by an error that meant their wishes about the use of their organs after death were wrongly recorded.
An investigation has found that 45 of those for whom wrong records were stored have since died – and in approximately 20 cases organs were taken where consent had not been given.

Donors can give permission for any of their organs to be taken, or provide more specific agreements. A glitch in the system more than a decade ago removed the distinctions expressed by people.
Many donors have strong views about what can be taken. Often consent is not given for eyes to be removed, while some people who agree to donate organs are uncomfortable with the idea of their body tissue being used in research.
Joyce Robins, from the pressure group Patient Concern said: "This Government has got an absolutely dreadful record when it comes to data, but it is absolutely horrific that such sensitive details were handled in such a careless way."
The NHS is about to contact approximately 20 families who allowed organs to be taken from their relations after being misinformed about what consent had previously been given.
It is illegal to remove organs without prior consent from the person who died or their next of kin. A view is sought from relations before decisions are taken. In the cases where errors were made, it is understood that families were asked for permission, but their decisions were based on misinformation about the wishes of their relations.
After detecting the fault last year, NHS Blood and Transplant, which holds the organ donation register, was able to correct 400,000 of the flawed records. But 400,000 more people will shortly be contacted to be told that the wrong information may be held about them, and asked to provide consent again.
Until fresh consent is obtained, organs will not be taken from any of those people in the event of death. "