Two minutes. One documented yes.
Register →The policy ask
Mandated choice makes the organ-donor question unskippable at the DMV — yes or no, on the record. No presumed consent, no cost, no one signed up without deciding.
Three ways to run a registry
The U.S. default
You are presumed to be a non-donor unless you actively register. The willing majority is never captured, because most people are simply never asked at the right moment.
“Presumed consent”
Everyone is presumed a donor unless they opt out. But opt-out countries don't automatically get more transplants — family authorization, OPO coordination, and clinical capacity are the real rate-limiters. Spain, the usual example, owes its results to its coordination infrastructure, not the default alone.
What OAI advocates for
Every adult is required to answer the question — yes or no. Nobody is presumed into anything. It respects autonomy, captures the willing majority, and produces a documented decision families can't override in the ambiguous moment.
The evidence
California's SB 1395 made the donor question mandatory at the DMV in 2011 — the only such law in the country. Our quasi-experimental analysis associated it with higher deceased-donor organ yield, with the largest effects on the most time-sensitive organs. Meanwhile 90%↗ of adults support donation but only 60%↗ are registered, and more than 100,000+↗ people are waiting.
Do something about it
The fastest way to move this is a constituent message. We've drafted one — open it, add your representative and your name, and send. Find who represents you first, then send the letter.
The email opens in your own mail app with the draft filled in. Nothing is sent until you send it.