Question: My husband and I are interested in a complete health care plan which includes organ donations. We would like to know the best way to make sure our wishes are carried out. We have durable powers of attorney and living wills, but are unclear about organ donation forms, and our lawyer has no information about this aspect of our planning. What are the age limits, if any, regarding organ donation? What is the best way to let our family know about our wishes? What if we change our minds before we die?

Answer: So long as you have the capacity to make the decision, you and your wife have the right to gift all or part of your bodies for medical or scientific uses. The document you use will depend on your state of residence. You may either amend or revoke this gift before you die.

Like giving blood, the organ donation system in the United States is voluntary. All states and the District of Columbia have passed the Uniform Anatomical Gift Act (U.A.G.A.) in either its 1968 or 1987 form. This law basically provides that if you are 18 years of age or older and have the capacity to make the decision, you can make a gift, effective at death, of all or part of your body for permitted purposes. According to federal law, the sale of organs is prohibited. State laws also include a list of people, including certain relatives, court-appointed guardians, and other persons who have the right to dispose of your body to make donations after or immediately prior to death. In some states, if authorized by the terms of a durable power of attorney, your agent is allowed to make the donation.

While an anatomical gift can be made by your will, this is probably not a good idea because your will might not be available at or near your time of death. The better practice is to include the gift in your health care power of attorney, on a card you carry with you, or, as is done in many states, by having your choice placed on your driver’s license. In all states, the gifting document must be signed by you, and some states require witnesses.

State law includes a list of acceptable organ recipients, which include medical schools, hospitals, doctors, or named individuals. After death and the removal of the organs, the remainder of your body is turned over to the person having the responsibility of assuring burial, cremation, or other arrangements – generally, the surviving spouse or next of kin. If you wish to donate your body to a medical school for research, you should make these arrangements before death directly with the school.

So long as you have capacity, you may change or revoke the gift at any time before death. Because death is such a traumatic time for families, in order to assure that your wishes are carried out, you should make your intention to donate your organs or body known to your family. If you don’t, your family will be in a position to “veto” your donation decision. Like other aspects of the planning process, full disclosure to family members avoids surprise and helps avert unpleasantness at a time when you can not express your desires.

According to what we have been able to find, assuming good heath, the upper age limitations for donors are as follows: kidney, ages 70-75; heart, ages 55-60; lung, age 70; heart-lung, age 55; liver, age 70; cornea, no age limit; skin, age 75; bone, age 55; and heart valves, age 55. For more information, you may wish to contact the American Red Cross, the Living Bank, and the United Network for Organ Sharing (UNOS).