In many states, the primary method of developing registries and presenting to the public the option to become part of the donor registry occurs through driver’s license renewal. This has several implications, which include the following:
- The issue of whether this presentation of the option constitutes informed consent.
- The way in which the question of whether an individual would like to join the registry is asked (i.e., as a question on the renewal form or verbally by department of motor vehicles or license office staff).
- The specific wording of the question, or the underlying tone of the individual asking the question (for example, asking the question in the negative rather than the positive, i.e., "You don’t want to donate your organs, do you?").
- The renewal cycle of the driver’s license, as renewals occur at less frequent intervals (States represented at the conference varied in renewal times from four to twelve years.)
- A mechanism for reaching those individuals who may not have a license (given that the primary method for entering individuals into the registry in most states is by utilizing driver’s license registration and renewal).
The group agreed that the process should start with universal eligibility by including in the registry anyone of sound mind, legal age, etc., even if other factors (e.g., the medical/social history) eventually preclude them from becoming donors at the time of death.