The Uniform Anatomical Gift Act was originally promulgated in 1968. By 1972, it had been adopted in every state and was acclaimed as the answer to the problem of organ availability for transplantation. But the demand for organs has increased dramatically. What seemed only a promise in 1968 -- heart transplants, liver transplants, heart/lung transplants -- have become commonplace. In 1987, the Uniform Anatomical Gift Act was thoroughly revised as a result of the 15 years' experience under the original act. The revisions are meant to make organ donations easier than the Act in its original form did, while restraining any excesses that might occur, as well.

Prior to the 1968 Act and its uniform adoption, it was not clear who had the rights to the dead body. Did it belong to the person it was before death? If so, did he or she exercise power over it after death by a will, which then had to be probated? Did the body belong to the closest relatives of the deceased person? If anything, the common law favored ownership by the nearest relatives, subject to powers the state exercises under its public health and autopsy statutes. But clarity on the issue was not evident.

The 1968 Act clarifies this fundamental issue. It provides that any adult person has the power to donate his or her own body upon death to a medical facility or to a physician to be used for medical purposes, including research and organ transplantation. A donation is effected by preparing a document indicating the intent to donate the body. The document is akin to a will in that it must be signed and witnessed as a will is. However, this document is not a will, and accomplishes a non-probate transfer of the body after death.

If a person does not prepare a written document, the 1968 Act sets out the priority list of relatives who may donate the body for those purposes. A spouse has the first priority, children the second. Other relatives follow in order of blood relationship. What the common law obscured, the 1968 Act clears up.

The 1987 Uniform Anatomical Gift Act retains these basic clarifications of the 1968 Act. A person exercises power over his or her own body by preparing a "document of gift" that controls whether or not the body may be donated for research or its organs. And, if there is no document at all, the priority list remains exactly as in the 1968 Act. What, then, are the improvements of 1987?

First, the "document of gift" is simpler. In the 1968 Act, it resembles a will with witnesses. In the 1987 Act, it is effective upon the signature of the donor. No witnesses are required. There is specific reference to the attachment of "documents of gift" to drivers' licenses, a common practice already in many states. But the removal of the requirement for witnesses makes it much easier for people to use the ready-made forms on the back of drivers' licenses.

The 1987 Act explicitly states that medical attendants can rely upon a "document of gift." No other person needs to consent to taking organs. This express language does not really change the 1968 Act, but relieves the anxieties of those in the medical setting who could not quite bring themselves to believe that the 1968 Act really allowed them to rely on the "document of gift."

In certain instances, the 1987 Act permits organs to be taken when there is no "document of gift" and consent to remove organs has not been obtained from a relative empowered to give consent. For this to happen, the appropriate authority (coroner or medical examiner) must have a specific request for organs from a medical person authorized under the Act to accept organs. Then a reasonable effort must be expended to locate any donor objections in the medical record and to ascertain if there are objections from anyone entitled to object to taking the organs. If there are no objections, the organs can be removed under the appropriate standards.

The 1987 Act requires a hospital to request every incoming patient to consider making a "document of gift." Each patient has to be asked if he or she has consented to donating organs. If yes, the "document of gift" is made a part of the medical record. If not, with consent of the attending physician, the option "to make or refuse an anatomical gift" must be discussed with the patient. If there is no record of objection to an anatomical gift, after death, the hospital must initiate discussion of a gift with anybody entitled to make such a gift. The "required request" idea was also incorporated into federal law in 1987, and imposes similar requirements upon hospitals paid under Medicaid and Medicare.

It should also be noted the 1987 Act expressly permits a person to execute a document that forbids the taking of all the body or specific organs, or that restricts the taking to certain physicians or hospitals. Once such restrictions are known to physicians and hospital staff, they must be strictly honored.

Except for this last provision expressly permitting a person to object to organ donation, the 1987 Act's innovations all serve the purpose of encouraging organ donations by making them easier and by increasing awareness of the need for donors. It is hoped that the 1987 Act will serve to increase the number of organs available to those who need them for continued life.

The 1987 Act, however, forbids the sale of organs. The ethical problem of commercial traffic in organs far outweighs any benefits that legalized sales might provide. The 1987 Act remains steadfast in service of the key feature of the 1968 Act -- voluntary donation from any person. It is still the best way.