The donor's family neither pays for, nor receives payment for, organ and tissue donation. Hospital expenses incurred before the donation of organs in attempts to save the donor's life and funeral expenses remain the responsibility of the donor's family. All costs related to donation are paid for by the organ procurement program or transplant center. A transplant team does not become involved until other physicians involved in the patient's care have determined that all possible efforts to save the patient's life have failed. The recovery of organs and tissues is conducted in an operating room under the direction of qualified surgeons and neither disfigures the body nor changes the way it looks in a casket.
Violators are subject to fines and imprisonment.
Among the reasons for this rule is the concern of Congress that buying and selling of organs might lead to inequitable access to donor organs with the wealthy having an unfair advantage. This policy enables hospitals and health care professionals to play a key role in increasing donation because families might otherwise not be aware of their right to donate. It required each participating hospital to establish written protocols for identification of organ donors and to notify an organ procurement organization designated by the Secretary of Health and Human Services of any potential donors it identifies. Since January 1988, the Joint Commission for the Accreditation of Healthcare Organizations has required its member hospitals, as a prerequisite for accreditation, to develop policies and procedures on the identification and referral of potential donors. OPOs are organizations that coordinate activities relating to organ procurement in a designated service area.