new and critical field for exploration. My hope is that it will be free for a fresh look and not bound by past investigative procedures. It requires imagination and boldness as well as sympathetic concern and proper procedures.

Thank you very much.

Senator HARRIS. Thank you very much, Dr. Brauer. I have a question or two, but I want to defer to the principal author of the resolution, Senator Mondale, who has another meeting he has to attend, and may have some comments or questions.

Senator MONDALE. Dean, I am very, very pleased by your testimony It highlights many of the considerations that bothered me and led me to propose, with Senator Harris and others, Joint Resolution 145, which is the basis for today's hearings. I do not think I have any ques tions. I think I will just say "Amen."

Senator HARRIS. Thank you very much, Senator Mondale. I know you do have somewhere else you have to be, but we appreciate your coming here this morning briefly.

Dr. Brauer, I take it from what you say that you find that from your consideration of this resolution that it is appropriate that there be on the proposed commission those whose field of concern or competence is outside that of medicine alone, is that so?

Dr. BRAUER. That is certainly true. I hope I made clear that the consequences of what the scientific community is doing is so great for the totality of society, it involves every segment of our highly pluralistic society, that any such commission ought to have representatives of these various facets of society. I sincerely hope there will be non scientist representatives.

Senator HARRIS. There have been some who thought that any such considerations as these ought to be made only by the physician involved in the individual case or cases. There have been others who have thought that if this commission is to be created it ought to be dominated by physicians. It seems to me that both probably lose sight of the fact that this commission is not going to exercise any control nor is it intended that it should. Control is a word that worries people. And I, for one, cannot see any harm that might come from a full airing of the questions involved here, and a conscious recognition that there are rather serious kinds of moral, ethical and legal questions involved. Would you agree?

Dr. BRAUER. I most certainly would. I read the resolution carefully, and it was quite clear to me that at no point did it intend control, but rather its purpose is to promote the full, frank public discussion of all of these issues that are of such tremendous consequences for the whole of our society. This is why I find myself fully supporting the resolution, and hence would have to say yes to your question. I think it is imperative that this type of commission be very broad in makeup. Otherwise the fundamental issues will not be confronted. I think they could be missed.

Senator HARRIS. I want to say again how much we appreciate your coming here. I think your testimony will add very much to the strength of these hearings. Thank you.

Our second witness this morning is Prof. E. Blythe Stason, professor of law at Vanderbilt Law School in Nashville.

Without objection we will place in the record at this point a biographical sketch concerning him. We are very pleased you came here this morning, and we will be pleased to hear from you at this time.

Biographical Sketch: E. Blythe Stason

Professor of Law, Vanderbilt Law School, Nashville, Tenn.; formerly, dean, University of Michigan Law School, Ann Arbor, Mich.

A.B., University of Wisconsin; B.S., Massachusetts Institute of Technology; J.D., University of Michigan.

Instructor, electrical engineering, University of Pennsylvania, 1916–17; assistant professor, electrical engineering, University of Michigan, 1919-22; practiced law, Sioux City, Iowa, as member of firm Stason & Stason, 1922-24; professor of law, University of Michigan; provost of the university, 1938–44; dean of the Law School, 1939-60; administrator, American Bar Foundation, Chicago, 1960-64; professor of law, Vanderbilt University, 1964—

Michigan commissioner in National Conference of Commissioners on Uniform State Laws; member Michigan Constitution Revision Study Commission, 1941; Michigan Tax Study Commission, 1945; chairman, Michigan Anti-Subversive Study Commission, 1950; member, U.S. Attorney Generals Committee on Administrative Procedure, 1953-54; Hoover Commission Task Force on Legal Services and Practices of Executive Branch, U.S. Government, 1953–54; Managing Director, Fund for Peaceful Atomic Development, 1955– ; Director, Institute for Training in Citizenship, New York University, 1956–59; chairman, Michigan Commission of Tax Administration, 1957-58; member, Council on Foreign Relations, 1958

Recipient of award for outstanding research in law and government, American Bar Foundation, 1965; fellow, American Bar Foundation; member, American Law Institute, American Judicature Society (director 1940-52), University of Michigan Musical Society (director 1938– ), Inter-American (Council, 1950), American, Michigan (Secretary, editor Journal 1929-35; Committee-at-large, 1946-61) Bar Associations, S.A.R., Order of the Colf, Gamma Eta Gamma. STATEMENT OF E. BLYTHE STASON, PROFESSOR OF LAW AT VANDERBILT LAW SCHOOL, VANDERBILT UNIVERSITY, NASHVILLE, TENN.

Professor STASON. Thank you, Mr. Chairman. It is a privilege to be invited to appear before you and the committee. I am glad to be here. The list of subjects that might be explored by a Presidential Commission is certainly a long one. The subjects mentioned by the gentleman who preceded me, Dr. Brauer, are of vital importance. But there are many others. I think of a study of alcoholics, alcoholism. There are about 6 million people in this country today, many of whom would be highly productive members of society if they were not compulsive drinkers. This is a large problem for health science and Society. I think of narcotics today. I see narcotics invading our educational institutions, and I observe it with some dismay. The narcotics pusher is a criminal, of course. The narcotics user may be an ill person or certainly a very badly misguided person. This is a subject that needs exploration.

Medicare and medicaid are other subjects. Abortion and population control are other subjects. Psychiatry, the science of the mind, is one of the frontiers of medicine. And then of course we note genetics and genetic controls, human transplants, and human experimentation. All of these are in the list of subjects that fall well within the purview of the proposed commission.

In my statement, I should like to limit consideration to just two of these several possibilities. First I am going to discuss the social values

and some of the legal problems of anatomical transplantation to human patients in need of new parts or organs and the need of revising the laws to facilitate such gifts, and, second, I shall discuss certain ethical and legal problems that arise in connection with modern day clinical research.

Transplantation is a subject with which I have become familiar over the past 3 years as a result of serving as chairman of a drafting committee of the National Conference of Commissioners on uniform State laws. The conference has been preparing a Uniform Anatomical Gift Act. The act is nearly in final form. It will probably be given final approval at the annual conference next July in Philadelphia.

We believe that this act will substantially improve the legal environment within which transplantation can go on for the benefit of mankind, that it will encourage the development of this new medical frontier-indeed, it will make a substantial contribution, we believe, to providing years of life for many who would otherwise die.

May I say a word, Mr. Chairman, about the National Conference of Commissioners with which you are doubtless familiar. It is a longestablished institution, established in 1892. It is made up of commissioners from each of the 50 States, plus the District of Columbia, and the Commonwealth of Puerto Rico.

Most of the commissioners are appointed by their respective Governors, so it is a quasi-official organization. At the same time it is an affiliate of the American Bar Association.

The National Conference prepares uniform acts for consideration by the State legislatures. All of its acts are approved by the House of delegates of the American Bar Association.

There are about 100 acts that are now on the active list of the National Conference. Some of them have made important contributions to State legislation, and to uniformity between the several States. Perhaps one of the best examples is the Uniform Commercial Code which has now been adopted in all but one of the States of the Union.

I have been a member of the National Conference for a longer period than I care to remember. I was appointed by the Governor of Michigan in 1933. But I have no authority whatsoever to speak for the National Conference, and I do not attempt to do so. I would like to say just a word, however, about my own feelings concerning the proposed Presidential Commission.

I feel that if the proposed Commission is established, it will render valuable assistance in a very timely and very important field.

There is a great deal to be done, Mr. Chairman, in sorting out fact from fiction in this field, sorting out science from speculation, and drama from achievement. There is much to be done in the way of estabishing important guidelines.

Now in regard to the transplantation ethical and legal environment. The facts are well known, of course. We know that whole bodies are dissected in teaching and research laboratories. We know that the ransplantation of parts has assumed an important stature in recent rears. Such procedures involve skin grafts, bones, arteries, blood, -orneas, kidneys, livers, and more recently even hearts.

The less dramatic elements, such as the transplantation of bones, do not often get into the public eye. I am told, however, by the authoriies at the U.S. Naval Medical Center that they perform about 4,000

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or 5,000 transplantations of bones for every transplanted kidney. Se this is a less dramatic, but a much more common application.

I understand that renal transplants alone could save 6,000 to 10,000 lives per year, if a sufficient supply of kidneys were available, and if the legal environment permitted a ready use of them.

Now, the problems in connection with transplantation are several. In the first place, the problem of logistics is formidable. The kidney must be removed within 30 or 45 minutes of death, and this is an important fact. It must be immediately transferred to the recipient, or it must be stored in some successful manner. The logistics become important, and this, of course, is a matter for the doctors and surgeons in the medical profession to work out as the years go by.

The second major obstacle is the shortage of medical personnel. This might well be one of the subjects for investigation by the Presidential Commission-shortage of personnel, scarcity of transplantation teams, and the fact that there simply are not enough skilled personnel on hand to meet the demand at the present time.

The third most formidable obstacle, however, and the one that concerns me more directly, is the legal situation. There are statutes on the books at the present time in many States which offer a limited protection. About forty States have statutes concerning gifts of body parts, and a few more provide for gifts of corneas only. So there is a legal framework at the present time, but as we shall see, this legal framework is not fully satisfactory.

Let me speak just briefly about the legal aspects.

Transplantation may be effected from one living person to another living person, or from a dead person to a living person. If the former is involved, all that is required is appropriate informed consent anthorizing the surgical removal on the one hand, and the implantation on the other. If utilization of all or any part of the body after death is intended, the legal problems become much more complicated.

The complications result in part from the variety of interests ir the dead body. The deceased had an interest during his lifetime which can be given certain postmortem effect, at least in most, but not all, States. After his death, his surviving spouse, or if none, the surviving child, or parent, or other relatives have certain interests that must be recognized and dealt with. Primarily, these are emotional interests connected with the dignity of the disposition of the body. Finally, the public has an interest, as, for example, in finding the cause of death when suspicious circumstances are involved. For this purpose, autopsies are prescribed by statute.

Additionally, there is a strong public interest in the availability of a sufficient number of human bodies and parts thereof to satisfy the needs of anatomy laboratories, teaching the next generation c doctors. These are the conflicting interests. They conflict to a greater or less extent, and the Uniform Anatomical Gift Act is designed to eliminate these legal difficulties and provide a legal framework within which the desire to give can be properly effectuated.

Now, there are some statutes on the books already, as I have indcated. Nearly 40 States have statutes of some kind or another. Many of them have been adopted in the last 15 to 18 years. The statutes differ as to content and coverage. Statutes differ in their enumeration of permissible donees and purposes for which gifts may be made. Tiy

differ as to the minimum age of the donor and the method of execution of the instruments of gifts. A gift executed in one State may or may not be effective in another State. In fact, several States specifically provide that the gift is effective only within the borders of that State. Many statutes fail to provide for revocation of the gift in case the donor changes his mind later or perhaps during his terminal illness. Very particularly, no statutes take care of the peripatetic American citizen. If citizen A executes a gift in State X and then goes on an automobile trip and dies in State Y, the surgeon in State Y that has custody of the body, and jurisdiction over the situation, even if he knows that there has been a gift made in State X, he may be in grave doubt as to whether or not it is a valid gift in State Y. And with only 30 minutes or so to resolve the legal questions, he cannot take time to get legal counsel involved.

And so the statutes that we have on the books now do not adequately take care of the peripatetic American citizen.

We hope that the Uniform Act will do so. The Uniform Act, if it is adopted fairly widely, or conceivably by all of the States, will provide the same legal framework in each State, and it will provide that a gift made in one State will be valid wherever the donor dies.

It is this area generally that the Uniform Act with which I have been working is involved.

The act includes six major features which I will just mention to you. They are all set forth in my prepared statement.

Senator HARRIS. We are going to place the entire statement in the record.

Professor STASON. Then I will not develop it at length.

In the first place, the act provides that a person may make a valid gift during his lifetime that cannot be upset after his death by his next-of-kin. And then it provides for the order of priority of relatives in case the gift is not made during the lifetime-the order of priority authorizing the relatives to make the gift. If there is a conflict among the relatives, this is taken care of.

Then, second, we very carefully deal with the donees and their purposes. We want to avoid anything like a black market, so the donees are specifically listed, they are to be licensed by the State, and the purposes for which the gift may be made are carefully outlined.

Then, third, we provide for the execution of the gift, and perhaps the most significant feature of this section is the fact that we provide that an individual who wants to make a gift may carry a card in his pocket, and this card evidences the gift. If he dies in another State outside of his normal environment and the card is found in his effects, the surgeon who finds that card can rely upon it and if he proceeds in good faith, he will be protected. The card-carrying technique is, we think, something of value.

And then we provide for the delivery of the document; that is, we eliminate the necessity for the delivery of the document. We provide for revocation; and finally we provide for the legal effect, namely the protection of the surgeon who in good faith relies upon the evidence of the gift, without any notice of revocation, who proceeds to execute the gift.

Some of the statutes in the States cover some of these points, but none of the statutes cover all of them adequately. And so we have felt