Medical examiners have a substantial responsibility in investigating and reporting deaths, and therefore have the potential to take a key role in the organ and tissue donation process. Nevertheless, only a relatively limited amount of state legislation has been enacted recently to address this issue. Recent measures in New Jersey and Texas requiring medical examiners to justify any refusals of organ donation should significantly decrease this barrier to the use of registries. By requiring greater accountability on the part of medical examiners for these actions, this measure makes the process more transparent to procurement personnel.
Additionally, allowing a medical examiner to authorize donation (in lieu of next of kin consent) facilitates the donation process by decreasing the number of individuals that must be consulted to begin donation procedures and, further, represents a step toward implementation of advance directives. Legislation more specifically clarifying the role of medical examiners, such as that described here, can help to ensure that the responsibilities of examiners during the donation process are clearly defined.