I answered the first few in a daze, still a little stunned by the prompt, courteous service. Then the question about organ donation jarred me awake.
I paused for a few seconds, then answered with my first instinct, "no," and moved on.
Actually, I am in favor of organ donation, as are 83 percent of Americans, according to a Gallup Poll reported by ABC News. But I also sided with the majority when I chose not to be a potential donor. Only 28 percent of Americans signed up to donate, the poll reported.
In Philadelphia, we follow that trend. As of June 2003, only 29 percent of Philadelphia drivers answered "yes" to organ donation, well below the state average of 41 percent, according to the Gift of Life Donor Program, the region's official organ-donor organization. The numbers were higher in the suburbs, although Chester County, at 51 percent, was the only county to break the 50 percent mark.
So why is the spirit willing but the potential donor pool weak? I thought back to that day at the driver's license center. The few seconds I took to think about being a donor were a blur of images - mangled wreckage, blood-stained upholstery, a lifeless cadaver harvested of vital organs. Gruesome, dramatic images too easily dismissed by clicking "no."
What didn't come to mind were the more than 80,000 people on the waiting list for corneas and organs such as hearts, lungs, kidneys and livers.
In 2002, more than 6,000 people died while waiting for organs, according to the United Network for Organ Sharing, in Richmond, Va. The national donor pool is further reduced when family members refuse to allow the organ donation to occur despite the wishes of their deceased loved ones.
Grim images prevented me from answering "yes" that day, but after thinking about it awhile, I also needed to clarify some myths about organ donation. Yes, an open-casket burial is possible; no, families of deceased donors do not have to contribute money for the transplants; no, the organs don't go to celebrities or rich people first; and yes, doctors do everything possible to save potential donors' lives, according to the Gift of Life Donor Program.
Maybe there is a way to avoid the myths and circumvent the squeamish stomachs. In November, two Columbia University researchers published an article in Science Magazine concluding that our country's donor pool would increase dramatically with an "opt-out" policy. It would include everyone as a potential donor - automatically - unless someone requests otherwise in writing.
Many European countries, such as France and Austria, have opt-out policies, and registered donors in those countries ranged from 85 percent to 99 percent. In "opt-in" nations, such as the United Kingdom and Germany, which have policies similar to ours, registered donors ranged from 4 percent to 27 percent, according to the article.
So, if more than 83 percent of us approve of organ donation, why don't we just adopt an opt-out policy?
There is no doubt that this is a tricky ethical subject that would require extensive public debate. New technology and techniques now allow for such things as limb transplants, as well as face transplants.
But with the lives that could be saved by increasing the number of organ donors, an "opt-out" policy is at least worth discussing. In the meantime, I'm not going to wait until the next time I have to renew my driver's license. I have decided to sign a donor card, slip it into my wallet, and inform my family of the choice that I made.
Patrick Guinan lives and writes in Drexel Hill.
Pennsylvania Driver's License Donor Registry Statistics
County Total Drivers Organ Designation Percent
Bucks 466,422 220,052 47.18
Chester 310,655 158,107 50.89
Delaware 403,109 176,260 43.73
Montgomery 605,013 281,053 46.45
Philadelphia 908,323 264,993 29.17