Colorado Organ Donation and Advance Directives: Documenting Your Anatomical Gift

Most Coloradans who want to be organ donors check the box when renewing their driver's license and assume they're covered. But the DMV designation is just one piece — integrating organ donation wishes into your advance directive creates a legally comprehensive declaration that prevents family disputes and ensures your wishes are honored even if your license is expired, lost, or unavailable.

How Colorado's Anatomical Gift Law Works

Colorado adopted the Revised Uniform Anatomical Gift Act, which governs organ, tissue, and bone donation. Under this framework, you can make a legally binding anatomical gift through several mechanisms:

• A designation on your Colorado driver's license or state ID
• A signed donor card
• A statement in your advance directive documents (Living Will or MDPOA addendum)
• A witnessed oral declaration during your terminal illness

The most comprehensive approach is documenting your wishes in your advance directive alongside your other healthcare preferences. This creates a single reference point for your healthcare agent and medical team, eliminating the need to cross-reference multiple documents during a time-sensitive decision window.

What You Can Specify

Colorado law lets you control the scope of your donation with significant specificity:

Full donation — any organs, tissues, or bones needed for transplant, therapy, research, or education

Limited donation — only specific organs or tissues (for example, corneas and kidneys but not skin or bone)

Purpose restriction — donation only for transplant (not research), or only for medical education

Exclusion — explicitly refusing to donate specific organs or tissues while permitting others

If you make no anatomical gift declaration at all, Colorado law allows your next of kin to authorize donation after death. Some families find this acceptable; others want their wishes documented to prevent family disagreement during an already devastating time.

The Conflict Between Life Support and Donation

Here's where coordination between your Living Will and organ donation wishes becomes critical. If your Living Will directs withdrawal of all life-sustaining treatment and you also want to donate organs, there's a potential timing conflict: organs must be maintained with blood flow and oxygen until surgical recovery can occur.

Colorado law addresses this by permitting temporary maintenance of life support solely for the purpose of organ viability — even when the patient has otherwise refused life-sustaining treatment. However, this must be explicitly stated in your documents to avoid ambiguity. Without clear language, your healthcare agent may face an impossible choice between honoring your treatment refusal and facilitating the donation you wanted.

Your advance directive should explicitly address whether you consent to temporary life support maintenance (typically 24-72 hours) for the purpose of organ recovery after brain death determination.

The DMV Designation vs. Advance Directive

The DMV "donor heart" on your license is legally valid in Colorado. But it has practical limitations:

• It can't specify which organs or restrict purposes
• It may not be physically present when needed (lost wallet, expired license)
• It doesn't address the life-support maintenance question
• It can't be easily updated if your wishes change

Integrating donation wishes into your advance directive creates a more detailed, accessible, and updateable record. Your healthcare agent then has clear authority and guidance — rather than the hospital trying to locate a DMV record while coordinating with a transplant team on a tight timeline.

Family Authority After Death

If you have not made an anatomical gift declaration, Colorado's priority list for who can authorize donation after your death follows this order:

1. Healthcare agent named in your MDPOA (if the document grants post-death authority)
2. Spouse or civil union partner
3. Adult children
4. Parents
5. Adult siblings
6. Grandparents
7. Close friend

Any single person on this list can authorize or refuse donation in the absence of your written declaration. This means a family member who opposes donation can block it — even if you verbally expressed wishes to donate. Written documentation in your advance directive overrides family objections.

Documenting Your Decision

Whether you choose to donate or explicitly decline, put it in writing within your advance directive. A clear statement removes the burden from your family during their worst hours and prevents the situation where grieving relatives must make a decision they're unsure you would have wanted.

The Colorado Advance Directive & Living Will Kit includes an anatomical gift declaration that integrates with your Living Will, addresses the life-support maintenance question, and lets you specify exactly what you want donated and for what purposes.

See more Colorado guides →