A group of national transplant organizations has sent Health and Human Services Secretary Tommy Thompson a list of proposed initiatives that includes making an organ donor card have "binding legal effect, regardless of familial objections."

This highly controversial proposal, put forward in a memo drafted by the American Society of Transplant Surgeons, would dramatically change existing organ procurement practices, where surgeons never take organs from a prospective cadaver donor over objections of next-of-kin.

The memo clearly recognizes the volatile nature of this proposal, stating that the legislation needed to make an organ donor's wishes binding would also have to shield organ procurement organizations from "potential liability concerns."

Many transplant surgeons and physicians, together with many organ donor organizations, have long been strongly opposed to any effort to make donor cards binding, fearing that angry confrontations with next-of-kin could result in lawsuits and publicity that could have a chilling impact on organ donation.

The memo to Thompson, however, was signed by the American Society of Transplantation, the Association of Organ Procurement Organizations, the National Kidney Foundation, Transplant Recipients International Organization, the American Liver Foundation, the American Association for the Study of Liver Disease, the American Association of Tissue Banks, and the Juvenile Diabetes Research Foundation, International.

In addition to the proposal to make organ donor cards binding, the groups also proposed: