Are hospitals required to ask patients about their wishes concerning organ donation?  

No. Hospitals and critical access hospitals are not required to ask patients about their organ donation wishes unless it is required by law/regulation, organization policy/procedure or Organ Procurement Organization (OPO) agreement. If organ donation is specified in the patient's advance directive or verbally expressed by the patient, there should be documentation of the patient's wishes according to the organization's policy and procedure. The organization must honor the patient's wishes within the limits of the law or hospital capacity. Some organizations may not be capable of fully honoring the patient's wishes since they do not have the capability of sustaining life. The patient may need to be transferred and this should be in accordance with law/regulation and any applicable OPO agreement.