Maine Organ Donation and Advance Directives: How to Document Your Wishes

Your advance directive covers more than life-sustaining treatment. Part 3 of Maine's statutory advance health care directive lets you document anatomical gift preferences — specifying whether you want to donate organs, tissues, or your entire body, and to whom.

But here's the catch most people miss: your advance directive isn't the only place Maine checks for donation intent. If your paper directive says one thing and the Bureau of Motor Vehicles (BMV) registry says another, donation professionals have to sort out the conflict during the most time-sensitive window imaginable.

How Organ Donation Works in Maine's Advance Directive

Under the Revised Uniform Anatomical Gift Act, any Maine resident aged 16 or older can register as an organ and tissue donor. Your advance directive's Part 3 allows you to specify:

• What you want to donate — all organs and tissues, specific organs only, or your body for medical research
• Who receives the gift — a specific institution, transplant organization, or any recipient in need
• Any limitations — restrictions on which organs or purposes you authorize

When you die, donation professionals check two databases: the Maine state donor database (linked to your BMV record) and the National Donate Life Registry. They also check your advance directive if one is on file with the hospital.

The most recently executed document of gift is legally binding. This means if you registered at the BMV five years ago saying "donate everything" but your advance directive from last year says "organs only, no tissue," the advance directive controls.

Coordinating Your Directive with the Donor Registry

The safest approach is making sure every record says the same thing. Here's how:

Step 1: Decide your preferences. Choose between donating all organs and tissues, specific organs only, or declining donation entirely.

Step 2: Complete Part 3 of your advance directive. Write your preferences clearly. Sign with two witnesses as required by Maine law.

Step 3: Update your BMV record. Visit any BMV branch or update online. Make sure the designation matches your directive.

Step 4: Register nationally. Go to RegisterMe.org to add your preferences to the National Donate Life Registry.

Step 5: Tell your healthcare agent. Your designated agent needs to know your wishes because they may be asked to confirm donation decisions in real time.

Common Conflicts and How to Avoid Them

The biggest risk is contradictory records. A family member who opposes donation might point to an older document that says "no" while your current directive says "yes." Under Maine law, the most recent document controls — but conflicting records create delays during hours when organ viability is shrinking.

Another common issue: people assume that checking "donor" on their license covers everything. The BMV designation is valid, but it doesn't let you specify restrictions. If you want to donate organs but not tissue, or donate only to research, you need the advance directive's Part 3.

Donation is free to the donor's family and does not prevent an open-casket funeral. Organs and tissues are surgically removed in a way that preserves standard funeral options.

What Your Healthcare Agent Should Know

Your agent's authority over organ donation depends on what you've documented. If you've completed Part 3 of your directive, your agent follows those instructions. If you haven't documented preferences, Maine's priority hierarchy applies — your agent, then your spouse, then adult children, then parents, then siblings can authorize donation.

Tell your agent explicitly whether you want to donate and what limits apply. A verbal conversation isn't legally binding, but it helps your agent act quickly and confidently when time matters.

The Maine Advance Directive & Living Will Kit walks you through Part 3 with specific prompts for each donation decision, plus a distribution checklist so every record matches.

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