What you are describing is an "opt out" system and while not present here, Pennsylvania (among some other states) adopted a system some time ago where no family consent is required if the person has a signed donor card. NY State just changed its own donor registry to a "consent" system, where by if you register, it is to give your consent as a donor, as opposed to just putting your name on a list of intent. At no time however in the US was there ever a consideration of an opt out system that would deny the person the right to getting an organ if they chose to opt out of donation. I was an organ procurement coordinator here in upstate NY prior to leaving health care altogether, and I worked directly with transplant teams here in Rochester. What you are describing was a movement by de facto organizations with no link to the OPTN (Organ Procurement and Transplantation Network) such as Life Sharers, et. al. The idea of denial of transplantation based on consent was something that was flatly reject by UNOS, the United Network for Organ Sharing, that oversees all facets of donation and transplantation in the US, and manages the donor waiting list here in the States.