State lawmakers are faced, once again, with a plan to revamp the commonwealth's organ donation procedures.
Supporters of the changes say Pennsylvania once set the national standard for organ donations, but has since fallen behind. Proposals to increase education about being a donor and streamline the organ procurement process have failed to gain approval in the past two legislative sessions. Backers of the latest proposal are hoping third time's the charm.
Bruce Edwards is among those with his fingers crossed. The retired state trooper has seen two sides of organ donation: he had a cornea transplant decades ago, and several years ago, he allowed his daughter's organs to be donated after she was killed in a car accident.
Experts say more than 8,000 Pennsylvanians are on waiting lists for new organs. People die every year when they can't wait any longer. For Edwards, if there's a single hitch in the process of procuring organs or tissue, it's one hitch too many.
"When you look at this someone might say, well, it's one or two or three or four or five people in a year that don't get donated," Edwards said. "Well, take those five people and multiply it by five to eight organs that could have saved that many people."
The political hitch in the process of updating the organ donation law has been opposition from law enforcement groups. Prosecutors have said they couldn't support the proposed changes because of possible interference with death investigations. Now, the Pennsylvania District Attorneys Association is taking a neutral position on the proposal.
"I think we could live with it," said Cumberland County District Attorney Dave Freed, who has tracked the bill's permutations in recent years. "We're much closer than we were before."
County coroners still appear to be opposed, though the Pennsylvania State Coroners Association did not return a request for comment. The current proposal would still give them "turndown" power — the ability to halt organ and/or tissue donation for the sake of a death investigation. But coroners, who are elected at the county level, say the proposal puts too many burdens on them.
Under the legislation, coroners would have to show up, in person, to halt the organ donation process. They would also have to put their decision in writing.
"That part is just impractical," said Dauphin County Coroner Graham Hetrick. "I shouldn't have to expound on it, either written or in person."
He imagined a 2 a.m. call notifying him of a death: "I have to know all the details of that body, not just some of them. Some of them might be pattern wounds... some of it might be very subtle bruising... might be cracked ribs." Harvesting organs in that scenario, he said, would compromise the very indications that could help him determine if there was foul play.
"What we're trying to do," said Hetrick, "is speak for the dead."
Rep. Kerry Benninghoff (R-Centre), himself a former coroner, is holding hearings on the issue of organ donation in the House, where the measure's fate appears far less certain (it passed in the Senate last fall).
He opposes the proposed changes, and said he's sympathetic to coroners' views.
"I'm not here to speak on behalf of them. I'm not a coroner anymore, but I think they take their job very serious," Benninghoff said. "They realize they get one chance to collect evidence and do it right."
But he said he has other concerns about tipping the scales in favor of organ procurement organizations without knowing exactly how those changes might affect families of the deceased.
"I'm just questioning," he said, "how does the bill make more organs available, if that's the goal of the bill?"
And he wonders whether the topic itself is so uncomfortable that basic questions about the process of organ harvesting — how to opt-in, how to opt-out, how it's paid for — aren't being asked.
"The reality is, a lot of people don't understand any of this stuff," said Benninghoff. "It's not a topic that the average person wants to talk about."
