Like many of us, Jesse Smith probably wasn't thinking about death when he checked the organ donor box on his driver's license. But shortly after his 21st birthday, his heart stopped.
Upon investigating Smith’s death, the King County Medical Examiner's office got in touch with his mother, Nancy Adams, and asked permission to donate some of his brain tissue to the Maryland-based Stanley Medical Research Institute. After many assurances, and, Adams asserts, promises that they would use only a portion of his brain, she signed a waiver.
During the course of the autopsy, the brain and other organs were removed. Most were returned, though samples of other organs were sent to SMRI, along with the entire brain, which SMRI and the county claim Smith gave them permission to harvest en masse. Adams later saw a news special on organ donation that explained the relationship between the Medical Examiner's office and SMRI, realized her son's entire brain had been sent off, and "suffered from grief and depression, requiring psychological and psychiatric treatment," per the terms of a lawsuit she subsequently filed.
State law allows people to gift their organs to designated recipients—generally hospitals, transplant clinics, and researchers. When someone does that, the wishes of his next of kin are irrelevant. In Superior Court, King County and SMRI argued that because Smith had checked the box on his driver's license, Adams' permission wasn't needed in the first place. A judge agreed and threw the case out. But Adams appealed, and last week the state Supreme Court ruled unanimously that her lawsuit could go forward.
The court's decision hinged on SMRI's clinical class. Washington law includes a clause that says in a case like Smith's, where no designated recipient is named, only a hospital can receive the organs. But SMRI isn't a hospital, the court ruled, so they don't automatically qualify to receive donated organs. That means they need permission; and since whether or not SMRI was given permission to take the entire brain remains unresolved, the case has to be hashed out in a trial court.