Depending on the method by which additional donor cards are used in a state, this could represent either a barrier to increasing registered donors or a facilitative measure. If a state requires donor cards in addition to a driver’s license designation to adequately demonstrate decedents’ donation wishes, it becomes unclear if both are necessary to legally represent an advanced directive. A problem also arises if one piece of donor documentation (i.e., the donor card or the driver’s license) is changed at some point while the other remains unchanged. This could lead to ambiguity as to which document takes precedence in the event of brain death, or which designation is listed in the donor registry (i.e., which document information is recorded). The dual donor card-driver’s license designation represents a potentially significant barrier to the donor registry and the advanced directive by adding unnecessary and potentially ambiguous documentation.
Alternatively, additional donor documentation beyond designation on a driver’s license could facilitate entering more individuals into the donor registry. Many individuals may not carry a driver’s license, and would therefore be precluded from entering into the registry without an alternative means of donation designation. The donor card then offers an additional mechanism for entering into the state donor registry.