Just recently, the Organ Donor Center of Hawaii received a call from someone who had signed up to be an organ donor on his license. He was frantic to tell us that he no longer wanted to be a donor.

His reason? He had heard or read that an individual was kept on "life support" to preserve his organs. He mistakenly believed that the individual was alive and kept on support in order to get the organs. Of course, that's not true but this particular person was confused and frightened by terminology that is frequently misused.

Words are critical. We all know the important difference between love and like, between interesting and exhilarating. These words can define the future of a relationship or make or break a product. For people who are desperately waiting for a heart, kidney or other organ, a misunderstanding about words can be the difference between life and death.

The simple misuse of language can prevent people from signing up to become organ donors. If you have not prepared your family to support your decision to be an organ donor, they may refuse permission to use your organs for others simply because they don't understand the words being used.

Life and death. Although you'd think the definition is easy, advances in medical technology can make things terribly confusing.

By law, a person is dead at the time he or she has "irreversible cessation of spontaneous respiratory and circulatory functions" — in short, the person is no longer breathing and blood flow has stopped. Nice and simple.

There is also "brain death," which can occur while a body is on life support. According to law, brain death is the "irreversible cessation of all function of the entire brain, including the brain stem," in short, there is no hope that the body will ever be able to perform any bodily function such as breathing or blood flow on its own since the brain controls all functions. With brain death, the body no longer thinks or feels or experiences any sensation. To put it in contemporary terms, the brain is the chip that runs our computer. Take it out and nothing runs. It is a blank screen.

By law, before declaring brain death, two independent physicians must each perform a standard medical test to determine whether brain death has occurred. These tests must be done before any artificial means of support are withdrawn or before any organs can be removed for transplant.

A great deal of misunderstanding surrounds the words "life support." If a body can no longer perform vital functions well or naturally, medical devices — or life support — can now help keep a person alive through methods such as intravenous feeding, mechanical ventilation to provide oxygen or a heart/lung machine that takes over the function of the heart and lungs.

The difficulty in language arises after a person dies. Once a person has died, it is no longer "life support" and should not be referred to that way. No one — as is so often mistakenly said or written — is "kept alive" by life support after they are dead. It is now support to a body, or empty shell, to keep the heart and lungs pumping blood and oxygen to maintain the appearance of life so that loved ones can say goodbye or to maintain the viability of the organs so they can be transplanted. In some cases, artificial support is continued after a pregnant woman dies in order to give the fetus a chance to live.

These are not easy concepts, and certainly not ones to learn during the emotional turmoil of death. It is one of the reasons it so critical to inform and educate your family about your decision to become an organ donor. They are the ones who must know your wishes and fully understand what the procedures are. They are the ones who must give their permission to have your organs removed.

Help your loved ones understand your desire to save lives with your organs and tissue. Educate each other about the procedures that are involved at the critical time of decision. Go to www.organdonorcenterhawaii.org for information.

It is tragic to lose the opportunity to save as many as 25 lives because someone doesn't understand the language surrounding death. It is especially tragic for the 388 people in Hawai'i awaiting life-saving transplants.

Stephen Kula is executive director of Organ Donor Center of Hawaii. He wrote this commentary for The Advertiser.