The original Uniform Anatomical Gift Act (UAGA) is model legislation for states to emulate, and promote uniform laws among states. A revised version of the UAGA 2006 has now been adopted in most of the US, but the story still serves to remind us that ethical responsibilities do not end at the hospital doors, but include a duty to help shape healthcare legislation. Respect for patient autonomy requires that patients be fully informed about implications that organ donation may have for other aspects of end-of-life (EOL) care. Anesthesiologists have ethical duties to understand legislation that may affect their patients, to publicize concerns, and to press for legislation that adequately protects the rights of all patients. Legislative change requires the actions of just a few knowledgeable persons. This chapter also presents the case study of a man in critical condition, who wishes to be an organ donor.