How to Become an Organ Donor

If you want to become an organ donor, you need to communicate your wishes.
If you want to become an organ donor, you need to communicate your wishes.

If you want to become an organ donor, you should communicate those wishes to the people who will carry them out.

Organ donation is one of the most regulated aspects of the healthcare industry, and the legalities of being an organ donor have very unique considerations. Essentially, organ donation is the physical transfer of the body parts of a person (the donor) to another person through surgical means. Organ donation can occur during the donor’s lifetime or at the organ donor’s death. Here we’re focusing primarily on the transfer of organs at the time of the organ donor’s death.

Although the need for organ donations is exceptionally high worldwide, the supply is often low. The lack of clearly communicated and documented consent by a potential organ donor is one of the most common challenges to organ donation. Despite an individual’s desire to donate organs, a failure to follow the right protocol can render the individual’s decision unenforceable.

What You Can Donate

Scientific advancements now allow for a single donor to donate organs to up to seventy-five donees. Organ donors can provide their kidneys, liver, heart, lungs, and pancreas. Donors can also donate tissue such as bone, skin, tendons, corneas, bone marrow, and stem cells. There are even instances where hands and feet have been successfully transferred. However, for many of these organs, the transfer must be initiated within twenty-four hours. Additionally, each potential donor must be evaluated on a singular basis with respect to the particular organ at issue.

Alternatively, some donors are interested in donating their entire body to scientific research. If you are interested in this route, you must be careful to avoid organ donation opportunities because scientific research requires complete bodies. In such instances, identifying the scientific institute you are interested in donating to and working with that institute directly is the best method. As you work with them, be careful to document your specific intent to donate your remains to science.

Making Your Wishes Known

There are a number of ways to make your wishes regarding organ donation known and increase the likelihood that they will be enforced. The most effective approach is a comprehensive one. This involves registration as a donor, legal planning, and communication of your wishes. The first and most important step is registering as an organ donor, which you can do in two ways: (1) find your state’s unique registry on www.organdonor.org and register online or (2) register at your local department of motor vehicles. In the latter scenario, your license will likely state that you are an organ donor.

The next step you can take is ensuring your wishes are recorded in your estate planning documents. An advance healthcare directive and living will are key documents that can include your end-of-life wishes. Finally, to ensure that your wishes are known, communicate them to your friends and family. These are the people who will end up intimately involved with your end-of-life decisions. Carefully select your healthcare agent and clearly communicate to that agent your desire to donate your organs.

It is important to note that the steps described above should not be taken in isolation. This is particularly true regarding your estate plan and communication of your wishes to friends and family. If there are conflicts between your plan and what family members think your wishes are, some states give greater weight to the documents memorializing your wishes. Your estate plan should contain your wishes, as well as information on any donor registrations you have made. Your documented wishes should then be expressed to those closest to you and who will carry out your wishes after you pass away.

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The Difference Between an Executor, a Trustee and Other Fiduciaries

Who is the best person to be your executor, trustee, or agent?
Who is the best person to be your executor, trustee, or agent?

When putting together an estate plan, you need to choose wisely those you trust to carry out your intent. Many people wonder what is the difference between an executor and a trustee. But those aren’t the only roles you need to consider filling when putting together your estate plan. You also may need to name agents and guardians.

The people you designate for these positions are generally called “fiduciaries.” Because these people will play an important part in the success of your estate plan you need to know what these roles entail and what kind of person would be best suited for each position.

Here is a summary of what fiduciaries you may need in your estate plan:

  • Executor  – This is the person named in your will who has the responsibility for identifying what property you own, paying your debts and final expenses, filing final tax returns, and distributing the remaining assets to your beneficiaries. Often the executor has the authority to determine what assets make up a beneficiary’s share. The executor should be organized and able to make financial decisions. The executor needs to be impartial with regard to beneficiaries. He or she should be willing to communicate regularly with the beneficiaries and keep them informed.
  • Trustee – A trustee manages a trust. As opposed to the executor, this could be a long term position, depending on how long the trust is supposed to last. The trustee must be able to communicate with the beneficiaries and be responsive to their needs while following the terms of the trust. There are many kinds of trusts, so one person may be good as trustee for one kind of trust, but may not be appropriate for another kind of trust. For example, an adult child may be a good trustee for his or her own trust, but a poor choice as trustee of a trust created for his or her step parent.
  • Guardian of a Minor or Incapacitated Child The guardian of a child’s “person” has the responsibility for making sure that the child’s day to day physical needs are met (food, clothing, and shelter). The guardian assumes the care of the minor or incapacitated child or children upon the death or incapacity of the last of the child’s parents to die or become incapacitated. The child’s guardian should be someone who holds the same values you do and someone you trust to raise your child the way you would.
  • Agent Under Medical Power of Attorney – This is the person you appoint to make decisions regarding your medical treatment when your health care provider has determined that you cannot make your own medical decisions. This person should not be afraid or hesitant to ask you what kind of treatment you would want in certain situations. He or she needs to be able to make tough decisions and be committed to making decisions based on what you want and have expressed, not on their own wishes.  It’s important to have a frank discussion with your medical agent regarding the kinds of treatment you want or don’t want.
  • Agent Under a General Durable Financial Power of Attorney This is the person you appoint to step in when you are unable to take care of your own business affairs, but you also may appoint an agent to act on your behalf when you are not incapacitated. The agent will be responsible for handling your day to day tasks, such as paying bills, managing investments, paying for your care and medical expenses, signing tax forms, dealing with insurance, social security, etc. This person should be organized and able to make financial decisions and have the time to handle your affairs. Your agent may hire outside help, like a bookkeeper or a caregiver.

Certain positions, such as an agent acting under a power of attorney, for practical reasons should probably be filled by one person at a time. For other roles, such as trustee or executor, you may wish to name two or more people. Just remember, the more people involved in the decision making, the more cumbersome the process may become.

You should also name successor executors, trustees, agents and guardians to act in the event the first person you choose is unable to take on that role.

In some situations, a trust company is the appropriate choice for carrying out your instructions as to how assets should be distributed and beneficiaries cared for. Trust companies are impartial and can be effective in diffusing emotions that may arise between beneficiaries and an executor or trustee. Another option may be to name an individual and a trust company as co-executors or co-trustees. The individual may be sensitive to a beneficiary’s needs and a trust company can take care of investing and managing assets.

In any event, your estate planning attorney will be able to help you explore further which roles you need to fill in your estate plan and the best people for those roles.

If you’re interested in learning more about how a trust company works. See https://www.galliganmanning.com/how-does-a-trust-company-work/

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Different Kinds of Powers of Attorney

Many people know they should have a Will, but Powers of Attorney (POAs) may be even more important because they assist you during your lifetime.

Many people recognize they should have a Will.  But, in many situations, the most important planning document may be a well-drafted power of attorney as described in The Miami News-Record’s recent article entitled “Power of attorney options match different circumstances.”

When a person can’t make his or her own decisions because of health, injury, or other circumstances, a power of attorney (POA) is essential. A POA is implemented to help their loved ones make important decisions on their behalf. It helps guide decision-making, enhances comfort and provides the best care for those who can’t ask for it themselves. A POA permits the named individual to manage their affairs.  Unlike a Will, the client themselves are at risk if they don’t have a POA.

To know which type of POA is appropriate for a given circumstance, you should know about each one and how they can offer help. Now, keep in mind there more different kinds of powers of attorney than what I discuss here, but these apply to virtually everyone at some point.

Durable Financial Power of Attorney. This is the most common and is the default for most planning. These give a person decision making authority limited to the powers provided in it.  The term “durable” means that it continues to be in effect when you are incapacitated.

Some of the key issues to determine are whether you give the agent the ability to make gifts, including to whom they can gift, the ability to change beneficiary designations, change your estate planning documents and other issues.

Springing Power of Attorney. One key issue of the POA is when it starts.  For example, it can be effective immediately upon the execution of the documents, or it can start once the POA creator becomes incapacitated.  This is a “springing” power of attorney because it “springs” into action upon the event of incapacitated.   Some people may not feel comfortable granting someone else power of attorney, while they’re healthy. This POA takes effect only upon a specified event, condition, or date.

Medical Power of Attorney. Especially in a hospice setting, it permits another person to make medical decisions on the patient’s behalf, if they lose the ability to communicate. This includes decisions about treatment. In this situation, the agent takes the role of patient advocate and communicates with the physicians.

Limited Power of Attorney. This POA provides the agent with the authority to handle financial, investment and banking issues. It’s usually used for one-time transactions, when the principal is unable to complete them due to incapacitation, illness, or other commitments.  The most obvious example is a limited POA for real estate transactions.

Powers of attorney are far more complex and important than people realize, and the law changes on them frequently.  There are many other reasons to update your estate plan as well such as described here https://www.galliganmanning.com/twelve-reasons-to-update-your-estate-plan/   If you don’t have this document, ask a qualified elder law or estate planning attorney to help you create one.

Reference: The Miami (OK) News-Record (July 7, 2020) “Power of attorney options match different circumstances”

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