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Missouri

Refusal to make a gift, evidenced how, requirements · Missouri

# Missouri: how to refuse organ donation

In plain English

In Missouri you can refuse to donate by signing a record, in your will, or, during a terminal illness or injury, by telling at least two adults, one of whom has no interest in the decision.

Effect of an unrevoked refusal

> Except as otherwise provided in subsection 8 of section 194.240, in the absence of an express, contrary indication by the individual set forth in the refusal, an individual's unrevoked refusal to make an anatomical gift of the individual's body or a part bars all other persons from making an anatomical gift of the individual's body or the part.

Mo. Rev. Stat. § 194.235

If you came here to get off the registry

## Is removing the donor designation enough in Missouri?

Taking your name off the organ donor registry is a revocation. So is [removing the designation from your driver’s license](https://wearabledocs.com/remove-organ-donor-from-license). Under Mo. Rev. Stat. § 194.240, Missouri law treats a revocation and a refusal as two different things, and only the refusal settles it.

A revocation withdraws the gift you made. It does not stop anyone else from making the gift for you. Only a refusal does that, and Mo. Rev. Stat. § 194.235 is the section that says so. It has to be signed.

Both provisions are quoted in full below, from Missouri’s own code.

What Missouri asks

## What you need to make a refusal in Missouri

**Act**

2006 revision

**Enforcement**

An unrevoked refusal bars all other persons from making the gift.

**Signing it yourself**

No witnesses required by the statute.

**If someone signs at your direction**

Two adults. At least one of the two must be a disinterested witness; the other may be anyone, including a family member.

**Notary**

Not required.

**Missouri law**

Mo. Rev. Stat. §§ 194.235, 194.240

**Statute read**

2026-09-02

Refusal to make a gift, evidenced how, requirements · Person other than donor barred from making, amending, or revoking donor's gift — revocation not a bar to making a gift — parent may revoke or amend a gift of a child

## The statute itself

Quoted from Missouri’s enacted code, in full and unedited.

How a refusal is made (1.)

> An individual may refuse to make an anatomical gift of the individual's body or part by: (1) A record signed by: (a) The individual; or (b) Subject to subsection 2 of this section, another individual acting at the direction of the individual if the individual is physically unable to sign; (2) The individual's will whether or not the will is admitted to probate or invalidated after the individual's death; or (3) Any form of communication made by the individual during the individual's terminal illness or injury addressed to at least two adults at least one of whom is a disinterested witness.

Mo. Rev. Stat. § 194.235

In plain English

Three ways: a signed record, your will, or telling two adults during a terminal illness or injury.

How it must be witnessed (2)

> A record signed under paragraph (b) of subdivision (1) of subsection 1 of this section shall: (1) Be witnessed by at least two adults at least one of whom is a disinterested witness, who have signed at the request of the individual; and (2) State that it has been signed and witnessed as provided in subdivision (1) of this subsection.

Mo. Rev. Stat. § 194.235

In plain English

Needed only when someone else signs for you because you cannot. Two adult witnesses, one with no stake in the decision.

What an unrevoked refusal does (4.)

> Except as otherwise provided in subsection 8 of section 194.240, in the absence of an express, contrary indication by the individual set forth in the refusal, an individual's unrevoked refusal to make an anatomical gift of the individual's body or a part bars all other persons from making an anatomical gift of the individual's body or the part.

Mo. Rev. Stat. § 194.235

In plain English

Once you have refused and not taken it back, no one else can donate your body or any part of it.

A revocation is not a refusal (2.)

> A donor's revocation of an anatomical gift of the donor's body or a part under section 194.230 is not a refusal and does not bar another person specified in section 194.220 or 194.245 from making an anatomical gift of the donor's body or a part under section 194.225 or 194.250.

Mo. Rev. Stat. § 194.240

In plain English

Taking back a gift (registry, license) is not the same as refusing. Others may still donate unless you refuse.

[Look up another state](https://wearabledocs.com/states)

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