The responsibility of the medical examiner is to determine the cause of death by performing an autopsy on the decedent’s body. Medical examiners typically have a great deal of authority over the disposition of a body, and therefore have the potential to take a key role in the donation process. Only two recent state legislative actions have significantly addressed the role of medical examiners in the donation process. First, in New Jersey and in Texas, medical examiners are required to justify their decision to deny the use of certain organs for donation. This situation is particularly relevant in cases of infant death, in which the cause of death may be less clear, and necessitate further investigation of the body (e.g., Sudden Infant Death Syndrome or child abuse). A second legislative action involves the state of Iowa, where medical examiners are able to authorize donation without next of kin consent.