Chapter
476
2007 -- S 729 SUBSTITUTE A AS AMENDED
Enacted 07/06/07
A N A C T
RELATING
TO HEALTH AND SAFETY -- UNIFORM ANATOMICAL GIFT ACT
Introduced
By: Senators Miller, Algiere, Connors, Perry, and C Levesque
Date
Introduced: February 15, 2007
It is enacted by the General Assembly as
follows:
SECTION 1. Chapter
23-18.6 of the General Laws entitled "Uniform Anatomical Gift
Act" is hereby repealed in its entirety.
CHAPTER
23-18.6
Uniform Anatomical Gift
Act
23-18.6-1.
Definitions. -- As used in this chapter:
(1)
"Anatomical gift" means a donation of all or part of a human body to
take effect upon
or after death.
(2)
"Decedent" means a deceased individual and includes a stillborn
infant or fetus.
(3) "Document
of gift" means a card, a statement or symbol attached to or imprinted on a
motor vehicle operator's or chauffeur's license,
inclusion in the Rhode Island Donor Registry, a
will, or other writing used to make an
anatomical gift.
(4)
"Donor" means an individual who makes an anatomical gift of all or
part of the
individual's body.
(5)
"Enucleator" means an individual who is licensed or certified by the
state board of
medical examiners and/or department of health
and/or federally designated eye procurement
organization to remove or process eyes or parts
of eyes.
(6)
"Hospital" means a facility licensed, accredited, or approved as a
hospital under the
law of any state or a facility operated as a
hospital by the United States government, a state, or a
subdivision of a state.
(7)
"Part" means an organ, tissue, eye, bone, artery, blood, fluid, or
other portion of a
human body.
(8)
"Person" means an individual, corporation, business trust, estate,
trust, partnership,
joint venture, association, government,
governmental subdivision or agency, or any other legal or
commercial entity.
(9)
"Physician" or "surgeon" means an individual licensed or
otherwise authorized to
practice medicine and surgery or osteopathy and surgery
under the laws of any state.
(10)
"Procurement organization" means federally designated eye or organ
procurement
organization accredited, and/or approved under
the laws of any state for procurement,
distribution, or storage of human bodies or
parts.
(11)
"State" means a state, territory, or possession of the United States,
the District of
Columbia, or the Commonwealth of Puerto Rico.
(12)
"Technician" means an individual who is licensed or certified by the
State Board of
Medical Examiners and/or department of health
and/or federally designated eye procurement
organization to remove or process eyes or parts
of eyes.
23-18.6-2.
Making, amending, revoking, and refusing to make anatomical gifts by
individual. -- (a) An individual who
is at least (18) years of age may:
(1) Make an
anatomical gift for any of the purposes stated in section 23-18.6-6(a);
(2) Limit an
anatomical gift to one or more of those purposes; or
(3) Refuse to
make an anatomical gift.
(b) An
anatomical gift may be made only by a document of gift signed by the donor or
by indicating consent to donate under chapters
10 and 10.1 of title 31. If the donor cannot sign,
the document of gift must be signed by another
individual, the next of kin, or designee and by two
(2) witnesses, all of whom have signed at the
direction and in the presence of the donor and of
each other, and state that it has been so
signed.
(c) If a
document of gift is attached to or imprinted on a donor's motor vehicle
operator's
or chauffeur's license, revocation, suspension,
expiration, or cancellation of the license does not
invalidate the anatomical gift.
(d) A document
of gift may designate a particular physician or surgeon in cases of living
relation donation and transplantation to carry
out the appropriate procedures. In the absence of a
designation or if the designee is not available,
the donee or other person authorized to accept the
anatomical gift may employ or authorize any
physician, surgeon, technician, or enucleator to
carry out the appropriate procedures.
(e) An
anatomical gift by will takes effect upon death of the testator, whether or not
the
will is probated. If, after death, the will is
declared invalid for testamentary purposes, the validity
of the anatomical fight is unaffected.
(f) A donor
may amend or revoke an anatomical gift, not made by will, only by:
(1) A signed
statement;
(2) An oral statement
made in the presence of two (2) individuals;
(3) Any form
of communication during a terminal illness or injury addressed to a
physician or surgeon; or
(4) The
delivery of a signed statement to a specified donee to whom a document of gift
had been delivered.
(g) The donor
of an anatomical gift made by will may amend or revoke the gift in the
manner provided for amendment or revocation of
will, or as provided in subsection (f).
(h) An anatomical
gift that is not revoked by the donor before death is irrevocable and
does not require the consent or concurrence of
any person after the donor's death, except in cases
where the deceased is under the age of eighteen
(18). In cases where the deceased is under the age
of eighteen (18), an anatomical gift shall be
made as set forth in section 23-18.6-3.
(i) An
individual may refuse to make an anatomical gift of the individual's body or
party
part by: (1) a writing signed in the same manner
as a document of gift; (2) a statement attached to
a donor's motor vehicle operator's or
chauffeur's license; or (3) any other writing used to identify
the individual as refusing to make an anatomical
gift. During a terminal illness or injury, the
refusal may be an oral statement or other form
of communication.
(j) In the
absence of contrary indications by the donor, an anatomical gift of a part is
neither a refusal to give other parts nor a
limitation on an anatomical gift under section 23-18.6-3
or on a removal or release of other parts under
section 23-18.6-4.
(k) In the
absence of contrary indications by the donor, a revocation or amendment of an
anatomical gift is not a refusal to make another
anatomical gift. If the donor intends a revocation
to be a refusal to make an anatomical gift, the
donor shall make the refusal pursuant to subsection
(i).
23-18.6-3.
Making, revoking, and objecting to anatomical gifts by persons other
than the donor. -- (a) Any member of the
following classes of persons, in the order of priority
listed, may make an anatomical gift of all or a
part of the decedent's body for an authorized
purpose, unless the decedent, at the time of
death, has made an unrevoked refusal to make that
anatomical gift:
(1) The spouse
of the decedent;
(2) An adult
son or daughter of the decedent;
(3) Either
parent of the decedent;
(4) An adult
brother or sister of the decedent;
(5) A
grandparent of the decedent; and
(6) A guardian
of the person of the decedent at the time of death.
(b) An
anatomical gift may not be made by a person listed in subsection (a) if:
(1) A person
in a prior class is available at the time of death to make an anatomical gift;
(2) (i) The
person proposing to make an anatomical gift knows of a written refusal or
written contrary indications by the decedent,
provided that the decedent has signed a document of
gift; or
(ii) If the
decedent has not signed a document of gift, and if the person proposing to
make an anatomical gift knows of any refusal or
any contrary indications by the decedent; or
(3) The person
proposing to make an anatomical gift knows of an objection to making an
anatomical gift by a member of the person's same
class or a prior class.
(c) An
anatomical gift by a person authorized under subsection (a) must be made by:
(1) A document
of gifts signed by the person or
(2) The
person's telegraphic, recorded telephonic, or other recorded message, or other
form of communication from the person that is
contemporaneously reduced to writing and signed
by the recipient.
(d) An
anatomical gift by a person authorized under subsection (a) may be revoked by
any member of the same or a prior class before procedures
have begun for the removal from the
body of the decedent, the physician, surgeon,
technician, or enucleator removing the part.
(e) A failure
to make an anatomical gift under subsection (a) is not an objection to the
making of an anatomical gift.
23-18.6-4.
Referral of death and authorization by medical examiner. -- (a)
The
medical examiner or his or her designee shall
provide the federally designated organ procurement
organization and other nonprofit federally registered
eye and tissue banks, in a timely manner, all
information necessary to facilitate organ and
tissue donation including, but not limited to, names
and available contact information of individuals
whose deaths have been reported to the medical
examiner's office and jurisdiction accepted.
(b) The
medical examiner may release and permit the removal of a part from a body
within that official's custody, for
transplantation or therapy, if:
(1) The
official has received a request for the part from a hospital, physician,
surgeon, or
procurement organization;
(2) A donation
has been authorized in accordance with section 23-18.6-2 or 23-18.6-3;
(3) The
official does not know of a refusal or contrary indication by the decedent or
objection by a person having authority to act as
listed in section 23-18.6-3(a);
(4) The
removal will be by a physician, surgeon, or technician; but in the case of
eyes,
by one of them or by an enucleator;
(5) The
removal will not interfere with any autopsy, investigation, procedure, or other
additional activity as deemed necessary by the
medical examiner required to arrive at a
reasonable cause and manner of death;
(6) The
removal will be in accordance with accepted medical standards; and
(7) Cosmetic
restoration will be done, if appropriate.
(c) The
medical examiner, or his or her designee, may permit the removal of the
anatomical gift to occur at the medical
examiner's office.
(d) A
permanent record of the names of the decedent, the person making the request,
the
date and purpose of the request, the part
requested, and the person to whom it was released should
be made by the hospital/physician/technician
(enucleator) and forwarded to the medical examiner
for his or her records.
(e) The
medical examiner, or his or her designee, shall be present during the removal
of
the anatomical gift if in his or her judgment
such attendance would, in the opinion of the medical
examiner or his or her designee, facilitate a
donation that would otherwise be denied.
(f) The
medical examiner, or his or her designee, may only deny removal of the
anatomical gift after explaining in writing or
verbally with subsequent written documentation to
the federally designated organ procurement
organization and other nonprofit federally registered
eye and tissue banks, reasons for determining
that those tissues or organs may be involved in the
cause of death.
23-18.6-5.
Routine inquiry and required request -- Search and notification. --
(a)
When, in the opinion of the attending physician
or other competent medical personnel that the
death of any patient is imminent or has
occurred, a representative designated by the hospital
administration shall notify the federally
designated organ/tissue procurement organization of
pending death. Except in cases in which the
patient is obviously unsuited for donorship, a
discussion of possible donation of
organs/tissues shall take place according to medical criteria
established by the federally designated
organ/tissue procurement organization and documentation
of notification and resultant options shall take
place in the patient's medical record. The hospital
administration shall actively support the
education of all appropriate hospital personnel
concerning organ and tissue donation on a
regular basis, and shall take all steps necessary to
assure full compliance with this chapter. The
federally approved organ procurement organization
shall from time to time be asked to render
opinion to the state hospital authority as to the
adequacy of hospital efforts in this area.
(b) If, at or
near the time of death of a patient, there is no medical record that the
patient
has made or refused to make an anatomical gift,
the hospital administrator or a representative
designated by the administrator shall discuss
the option to make or refuse to make an anatomical
gift and request the making of an anatomical
gift pursuant to section 23-18.6-3(a). The request
must be made with reasonable discretion and
sensitivity to the circumstances of the family. A
request is not required if the gift is not
suitable, based upon accepted medical standards,
established by the federally designated
organ/tissue procurement agency, for a purpose specified
in section 23-18.6-6. An entry must be made in
the medical record of the patient, stating the name
and affiliation of the individual making the
request, and of the name, response, reason for not
asking the next of kin or designee, and
relationship to the patient of the person to whom the
request was made. The director of the department
of health in conjunction with the federally
designated organ/tissue procurement organization
shall adopt regulations to implement this
subsection.
(c) The
following persons shall make a reasonable search for a document of gift or
other
information identifying the bearer as a donor or
as an individual who has refused to make an
anatomical gift:
(1) A law
enforcement officer, fireman, paramedic, or other emergency rescuer finding
an individual who the searcher believes is dead
or near death; and
(2) A
hospital, upon the admission of an individual at or near the time of death, if
there is
not immediately available any other source of
that information.
(d) If a
document of gift or evidence of refusal to make an anatomical gift is located
by
the search required by subsection (c)(1), and
the individual or body to whom it relates is taken to
a hospital, the hospital must be notified of the
contents and the document or other evidence must
be sent to the hospital.
(e) If, at or
near the time of death of a patient, a hospital knows that an anatomical gift
has been made pursuant to section 23-18.6-3(a)
of a release and removal of a part has been
permitted pursuant to section 23-18.6-4, or that
a patient or an individual identified as in transit to
the hospital is a donor, the hospital shall
notify the donee. The hospital shall cooperate in the
implementation of the anatomical gift or release
and removal of a part.
(f) A person
who fails to discharge the duties imposed by this section is not subject to
criminal or civil liability but is subject to
appropriate administrative sanctions.
(g) Each
hospital shall develop a protocol for addressing the issue of organ and tissue
donation whenever a death occurs in a hospital
and the intention of the deceased is unknown. The
protocol shall require that any deceased individual's
next of kin or other individual, as specified in
section 23-18.6-2, shall be informed of the
option to donate organs and tissue pursuant to chapter
18 of this title for any purpose specified in
section 23-18.6-3. The protocol shall encourage
reasonable discretion and sensitivity to the
family circumstances in all discussions regarding
donations of tissue or organs and may take into
account the deceased individual's religious beliefs
or obvious non-suitability for organ and tissue
donation in determining whether or not to make
the request.
(h) The
protocol shall require documentation of the request in the decedent's medical
record and, if no request has been made, of the
reasons no request has been made. Whether or not
consent is granted, the statement shall indicate
the name of the person granting or refusing the
consent and his or her relationship to the
decedent.
(i) Each
hospital shall submit a copy of the protocol to the department of health.
23-18.6-6.
Persons who may become donees -- Purposes for which anatomical gifts
may be made. -- (a) The following
persons may become donees of anatomical gifts for the
purposes stated:
(1) A
hospital, physician, surgeon, or federally designated organissue procurement
organization, for transplantation, therapy,
medical or dental education, research, or advancement
of medical or dental science;
(2) An
accredited medical or dental school, college, or university for education,
research,
advancement of medical or dental science; or
(3) A
designated individual for transplantation or therapy needed by that individual.
(b) An
anatomical gift may be made to a designated donee in the case of living related
donor degrees onee or donation of entire body to
a medical school for research prior to and well
in advance of death. If a donee is not
designated or if the donee is not available or rejects the
anatomical gift, the anatomical gift may be
accepted by any hospital.
(c) If the
donee knows of the decedent's refusal or contrary indications to make an
anatomical gift or that an anatomical gift by a
member of a class having priority to act is opposed
by a member of the same class or a prior class
under section 23-18.6-3(a), the donee may not
accept the anatomical gift.
23-18.6-7.
Delivery of document of gift. -- (a) Delivery of a document of
gift during the
donor's lifetime is not required for the
validity of an anatomical gift.
(b) If an
anatomical gift is made to a designated donee, the document of gift, or a copy,
may be delivered to the donee to expedite the
appropriate procedures at the time of death.
23-18.6-8.
Rights and duties at death. -- (a) Rights of a donee created by
an anatomical
gift are superior to rights of others except
with respect to autopsies under section 23-18.6-11(b).
A donee may accept or reject an anatomical gift.
If a donee accepts an anatomical gift of an entire
body, the donee, subject to the terms of the
gift, may allow embalming and use of the body in
funeral services. If the gift is of a part of a
body, the donee, upon the death of the donor and
before embalming, shall cause the part to be
removed without unnecessary mutilation. After
removal of the part, custody of the remainder of
the body vests in the person under obligation to
dispose of the body.
(b) The time
of death must be determined by a physician or surgeon who attends the
donor at death or, if none, the physician or surgeon
who certifies the death. Neither the physician
or surgeon who attends the donor at death nor
the physician or surgeon who determines the time
of death may participate in the procedures for
removing or transplanting a part unless the
document of gift designates a particular
physician or surgeon pursuant to section 23-18.6-2(d).
(c) If there
has been an anatomical gift, a technician may remove any donated parts and
an enucleator may remove any donated eyes or
parts of eyes, after determination of death by a
physician or surgeon.
23-18.6-9.
Coordination of procurement and use. -- Each hospital in this
state shall
establish agreements or affiliations with the
federally designated organ/tissue procurement
organization for coordination of procurement and
use of human bodies and parts.
23-18.6-10.
Sale or purchase of parts prohibited. -- (a) A person may not
knowingly,
for valuable consideration, purchase or sell a
part for transplantation or therapy, if removal of the
part is intended to occur after the death of the
decedent.
(b) Valuable
consideration does not include reasonable payment for the removal,
processing, disposal, preservation, quality
control, storage, transportation, or implantation of a
part.
(c) A person
who violates this section is guilty of a felony and upon conviction is subject
to a fine not exceeding fifty thousand dollars
($50,000) or imprisonment not exceeding five (5)
years, or both.
23-18.6-11.
Examination, autopsy, liability. -- (a) An anatomical gift
authorizes any
reasonable examination necessary to assure
medical acceptability of the gift for the purposes
intended.
(b) The
provisions of this chapter are subject to the laws of this state governing
autopsies.
(c) A
hospital, physician, surgeon, medical examiner, local public health officer,
enucleator, technician, or other person, who
acts in accordance with this chapter or with the
applicable anatomical gift law of another state
or a foreign country or attempt in good faith to do
so is not liable for that act in a civil action
or criminal proceeding.
(d) An
individual who makes an anatomical gift pursuant to section 23-18.6-2 or 23-
18.6-3 and the individual's estate are not
liable for any injury or damage that may result from the
making or the use of the anatomical gift.
23-18.6-12.
Acquired immune deficiency syndrome testing. -- Prior to any
organ,
tissue, or part of a human body being
transplanted in any human being, the donor shall be tested
for the presence of antibodies to the probable
causative agent for acquired immune deficiency
syndrome (AIDS), provided that this condition
shall not apply if there is a bona fide
documentable medical emergency which endangers
the life of any person. If the test for the
presence of the antibodies is positive, the
organ, tissue, or body part shall not be used.
23-18.6-13.
Transitional provisions. -- This chapter applies to a document
of gift,
revocation, or refusal to make an anatomical gift
signed by the donor or a person authorized to
make or object to making an anatomical gift
before, on, or after July 1, 1989.
23-18.6-14.
Uniformity of application and construction. -- This chapter
shall be
applied and construed to effectuate its general
purpose to make uniform the law with respect to
the subject of this chapter among states
enacting it.
23-18.6-15.
Severability. -- If any provision of this chapter or its
application to any
person or circumstance is held invalid, the
invalidity does not affect other provisions or
application of this chapter which can be given
effect without the invalid provision or application,
and to this end the provisions of this chapter
are severable.
SECTION 2. Title
23 of the General Laws entitled "HEALTH AND SAFETY" is hereby
amended by adding thereto the following chapter:
CHAPTER
18.6.1
REVISED UNIFORM
ANATOMICAL GIFT ACT
23-18.6.1-1.
Short title. – This chapter shall be known and may be cited as "The
Maureen A. Sebastianelli and Daniel B. Miller
Uniform Anatomical Gift Act."
23-18.6.1-2.
Definitions. – For purposes of this chapter, unless the context
otherwise
requires:
(1) “Adult”
means an individual who is at least eighteen (18) years of age.
(2) “Agent”
means an individual:
(i) authorized
to make health care decisions on the principal’s behalf by a power of
attorney for health care; or
(ii) expressly
authorized to make an anatomical gift on the principal’s behalf by any other
record signed
by the principal.
(3) “Anatomical
gift” means a donation of all or part of a human body to take effect after
the donor’s death for the purpose of
transplantation, therapy, research, or education.
(4) “Decedent”
means a deceased individual whose body or part is or may be the source
of an anatomical gift. The term includes a
stillborn infant and, subject to restrictions imposed by
law other than this chapter, a fetus.
(5) “Disinterested
witness” means a witness other than the spouse, child, parent, sibling,
grandchild, grandparent, or guardian of the
individual who makes, amends, revokes, or refuses to
make an anatomical gift, or another adult who
exhibited special care and concern for the
individual. The term does not include a person
to which an anatomical gift could pass under
section 11.
(6) “Document
of gift” means inclusion in a donor registry, a donor card or other record
used to make an anatomical gift. The term
includes a statement or symbol on a driver’s license or
identification card.
(7) “Donor”
means an individual whose body or part is the subject of an anatomical gift.
(8) “Donor
registry” means the Rhode Island Donor Registry established under section
31-10-26.1 as well as any other electronic
database that identifies donors and complies with
section 23-18.6.1-20.
(9) “Driver’s
license” means a motor vehicle or chauffeurs license or permit issued by the
department of motor vehicles, whether or not
conditions are attached to the license or permit.
(10) “Eye bank”
means a person that is licensed, accredited, or regulated under federal or
state law to engage in the recovery, screening,
testing, processing, storage, or distribution of
human eyes or portions of human eyes.
(11) “Guardian”
means a person appointed by a court to make decisions regarding the
support, care, education, health, or welfare of
an individual. The term does not include a guardian
ad litem.
(12) “Hospital”
means a facility licensed as a hospital under the law of any state or a
facility operated as a hospital by the United
States, a state, or a subdivision of a state.
(13)
“Identification card” means an identification card issued by the department of
motor
vehicles.
(14) “Know”
means to have actual knowledge.
(15) “Minor”
means an individual who is under eighteen (18) years of age.
(16) “Organ
procurement organization” means a person designated by the Secretary of
the United States Department of Health and Human
Services as an organ procurement
organization.
(17) “Parent”
means a parent whose parental rights have not been terminated.
(18) “Part” means
an organ, an eye, or tissue of a human being. The term does not
include the whole body.
(19) “Person”
means an individual, corporation, business trust, estate, trust, partnership,
limited liability company, association, joint
venture, public corporation, government or
governmental subdivision, agency, or
instrumentality, or any other legal or commercial entity.
(20)
“Physician” means an individual authorized to practice medicine or osteopathy
under the law of any state.
(21) “Procurement
organization” means an eye bank, organ procurement organization, or
tissue bank.
(22)
“Prospective donor” means an individual who is dead or near death and has been
determined by a procurement organization to have
a part that could be medically suitable for
transplantation, therapy, research, or
education. The term does not include an individual who has
made a refusal that is known by the procurement
organization.
(23)
“Reasonably available” means able to be contacted by a procurement organization
without undue effort and willing and able to act
in a timely manner consistent with existing
medical criteria necessary for the making of an
anatomical gift.
(24)
“Recipient” means an individual into whose body a decedent’s part has been or
is
intended to be transplanted.
(25) “Record”
means information that is inscribed on a tangible medium or that is stored
in an electronic or other medium and is
retrievable in perceivable form.
(26) “Refusal”
means a record created under section 7 that expressly states an intent to
bar other persons from making an anatomical gift
of an individual’s body or part.
(27) “Sign”
means, with the present intent to authenticate or adopt a record:
(i) to execute or
adopt a tangible symbol; or
(ii) to attach
to or logically associate with the record an electronic symbol, sound, or
process.
(28) “State”
means a state of the United States, the District of Columbia, Puerto Rico, the
United States Virgin Islands, or any territory
or insular possession subject to the jurisdiction of
the United States.
(29)
“Technician” means an individual determined to be qualified to remove or
process
parts by an appropriate organization that is
licensed, accredited, or regulated under federal or state
law. The term includes an enucleator.
(30) “Tissue”
means a portion of the human body other than an organ or an eye. The term
does not include blood unless the blood is
donated for the purpose of research or education.
(31) “Tissue
bank” means a person that is licensed, accredited, or regulated under federal
or state law to engage in the recovery,
screening, testing, processing, storage, or distribution of
tissue.
(32) “Transplant
hospital” means a hospital that furnishes organ transplants and other
medical and surgical specialty services required
for the care of transplant patients.
23-18.6.1-3.
Applicability. – This chapter applies to an anatomical gift or amendment
to,
revocation of, or refusal to make an anatomical
gift, whenever made.
23-18.6.1-4.
Who may make anatomical gift before donor's death. -- Subject to the
provisions of this chapter, an anatomical gift
of a donor’s body or part may be made during the
life of the donor for the purpose of
transplantation, therapy, research, or education by:
(1) the donor,
if the donor is an adult or if the donor is a minor and is:
(i)
emancipated; or
(ii) authorized
under state law to apply for a driver’s license because the donor is at least
sixteen (16) years of age;
(2) an agent of
the donor, unless the power of attorney for health care or other record
prohibits the agent from making an anatomical
gift;
(3) a parent of
the donor, if the donor is an unemancipated minor; or
(4) the donor’s
guardian.
23-18.6.1-5.
Manner of making anatomical gift before donor's death. -- (a) A donor
may make an anatomical gift:
(1) by authorizing
a statement or symbol indicating that the donor has made an
anatomical gift to be imprinted on the donor’s
driver’s license or identification card;
(2) in a will;
(3) during a
terminal illness or injury of the donor, by any form of communication
addressed to at least two (2) adults, at least
one of whom is a disinterested witness; or
(4) as provided
in subsection (b).
(b) A donor or
other person authorized to make an anatomical gift under this chapter may
make a gift by authorizing inclusion of the
donor on a donor registry, a donor card or other record
signed by the donor or other person making the
gift. If the donor or other person is physically
unable to sign a record, the record may be
signed by another individual at the direction of the
donor or other person and must:
(1) be
witnessed by at least two (2) adults, at least one of whom is a disinterested
witness,
who have signed at the request of the donor or
the other person; and
(2) state that
it has been signed and witnessed as provided in paragraph (1).
(c) Revocation,
suspension, expiration, or cancellation of a driver’s license or
identification card upon which an anatomical
gift is indicated does not invalidate the gift.
(d) An
anatomical gift made by will takes effect upon the donor’s death whether or not
the will is probated. Invalidation of the will
after the donor’s death does not invalidate the gift.
23-18.6.1-6.
Amending or revoking anatomical gift before donor's death. -- (a)
Subject to the provisions of this chapter, a
donor or other person authorized to make an
anatomical gift may amend or revoke an
anatomical gift by:
(1) a record
signed by:
(i) the donor;
(ii) the other
person so authorized; or
(iii) subject
to subsection (b), another individual acting at the direction of the donor or
the
other person so authorized if the donor or other
person is physically unable to sign; or
(2) a later-executed
document of gift that amends or revokes a previous anatomical gift or
portion of an anatomical gift, either expressly
or by inconsistency.
(b) A record
signed pursuant to paragraph (a)(1)(iii) must:
(1) be
witnessed by at least two (2) adults, at least one of whom is a disinterested
witness,
who have signed at the request of the donor or
the other person; and
(2) state that
it has been signed and witnessed as provided in subdivision (1).
(c) Subject to
the provisions of this chapter, a donor or other person authorized to make
an anatomical gift may revoke an anatomical gift
by the destruction or cancellation of the
document of gift, or the portion of the document
of gift used to make the gift, with the intent to
revoke the gift.
(d) A donor may
amend or revoke an anatomical gift that was not made in a will by any
form of communication during a terminal illness
or injury addressed to at least two (2) adults, at
least one of whom is a disinterested witness.
(e) A donor who
makes an anatomical gift in a will may amend or revoke the gift in the
manner provided for amendment or revocation of
wills or as provided in this chapter.
23-18.6.1-7.
Refusal to make anatomical gift – Effect of refusal. -- (a) An
individual
may refuse to make an anatomical gift of the
individual’s body or part by:
(1) a record
signed by:
(i) the
individual; or
(ii) subject to
subsection (b), 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 (2)
adults, at least one of whom is a disinterested
witness.
(b) A record
signed pursuant to paragraph (a)(1)(ii) must:
(1) be
witnessed by at least two (2) 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 paragraph (1).
(c) An
individual who has made a refusal may amend or revoke the refusal:
(1) in the
manner provided in subsection (a) for making a refusal;
(2) by
subsequently making an anatomical gift pursuant to the provisions of this
chapter
that is inconsistent with the refusal; or
(3) by
destroying or canceling the record evidencing the refusal, or the portion of
the
record used to make the refusal, with the intent
to revoke the refusal.
(d) Except as
otherwise provided in this chapter, 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 part
bars all other persons from making an anatomical
gift of the individual’s body or part.
23-18.6.1-8.
Preclusive effect of anatomical gift, amendment or revocation. -- (a)
Except as otherwise provided in this section, in
the absence of an express, contrary indication by
the donor, a person other than the donor is
barred from making, amending, or revoking an
anatomical gift of a donor’s body or part if the
donor made an anatomical gift of the donor’s body
or part in accordance with the provisions of
this chapter.
(b) A donor’s
revocation of an anatomical gift of the donor’s body or part shall not be a
refusal and does not bar another authorized
person specified in this chapter from making an
anatomical gift of the donor’s body or part.
(c) If a person
other than the donor makes an unrevoked anatomical gift of the donor’s
body or part, or an amendment to an anatomical
gift of the donor’s body or part, another person
may not make, amend, or revoke the gift of the
donor’s body or part under the provisions of this
chapter.
(d) A
revocation of an anatomical gift of a donor’s body or part by a person other
than the
donor does not bar another person from making an
anatomical gift of the body or part under the
provisions of this chapter.
(e) In the
absence of an express, contrary indication by the donor or other person
authorized to make an anatomical gift in accordance
with this chapter, an anatomical gift of a part
is neither a refusal to give another part nor a
limitation on the making of an anatomical gift of
another part at a later time by the donor or
another person.
(f) In the absence
of an express, contrary indication by the donor or other person
authorized to make an anatomical gift in
accordance with this chapter, an anatomical gift of a part
for one or more of the purposes set forth in
section 23-18.6.1-4 is not a limitation on the making
of an anatomical gift of the part for any of the
other purposes by the donor or any other person
under the provisions of this chapter.
(g) If a donor
who is an unemancipated minor dies, a parent of the donor who is
reasonably available may revoke or amend an
anatomical gift of the donor’s body or part.
(h) If an
unemancipated minor who signed a refusal dies, a parent of the minor who is
reasonably available may revoke the minor’s
refusal.
23-18.6.1-9.
Who may make anatomical gift of decedent's body or part. -- (a)
Subject
to subsections (b) and (c) and unless barred by
this chapter, an anatomical gift of a decedent’s
body or part for purpose of transplantation,
therapy, research, or education may be made by any
member of the following classes of persons who
is reasonably available, in the order of priority
listed:
(1) an agent of
the decedent at the time of death who could have made an anatomical gift
pursuant to this chapter immediately before the
decedent’s death;
(2) the spouse
of the decedent or the certified domestic partner of the decedent as defined
in subsections 36-12-1(3) and 45-19-4.3(b) or
any other provision of state law;
(3) adult
children of the decedent;
(4) parents of
the decedent;
(5) adult
siblings of the decedent;
(6) adult
grandchildren of the decedent;
(7)
grandparents of the decedent;
(8) an adult
who exhibited special care and concern for the decedent, who is familiar with
the decedent’s personal values, and who had
maintained regular contact with the decedent prior to
his or her death; provided, however, it shall
not include any medical personnel caring for the
decedent at the time of or immediately leading
up to the decedent’s death; and
(9) the persons
who were acting as the guardians of the person of the decedent at the time
of death.
(b) If there is
more than one member of a class listed in the previous subsection which is
entitled to make an anatomical gift, an
anatomical gift may be made by a member of the class
unless that member or a person to which the gift
may pass under the provisions of this chapter
knows of an objection by another member of the
class. If an objection is known, the gift may be
made only by a majority of the members of the
class who are reasonably available.
(c) A person
may not make an anatomical gift if, at the time of the decedent’s death, a
person in a prior class under subsection (a) is
reasonably available to make or to object to the
making of an anatomical gift.
23-18.6.1-10.
Manner of making, amending or revoking anatomical gift of
decedent's body or part. -- (a) A person authorized
to make an anatomical gift under section 23
18.6.1-9 may make an anatomical gift by a document
of gift signed by the person making the gift
or by that person’s oral communication that is
electronically recorded or is contemporaneously
reduced to a record and signed by the individual
receiving the oral communication.
(b) Subject to
subsection (c), an anatomical gift by a person authorized under section 23
18.6.1-9 may be amended or revoked orally or in
a record by any member of a prior class who is
reasonably available. If more than one member of
the prior class is reasonably available, the gift
made by a person authorized under section
23-18.6.1-9 may be:
(1) amended
only if a majority of the reasonably available members agree to the
amending of the gift; or
(2) revoked
only if a majority of the reasonably available members agree to the revoking
of the gift or if they are equally divided as to
whether to revoke the gift.
(c) A
revocation under subsection (b) is effective only if, before an incision has
been
made to remove a part from the donor’s body or
before invasive procedures have begun to
prepare the recipient, the procurement
organization, transplant hospital, or physician or technician
knows of the revocation.
23-18.6.1-11.
Persons that may receive anatomical gift – purpose of anatomical gift. -
- (a) An anatomical gift may be made to the
following persons named in the document of gift:
(1) a hospital;
accredited medical school, dental school, college, or university; organ
procurement organization; or other appropriate
person, for research or education;
(2) subject to
subsection (b), an individual designated by the person making the
anatomical gift if the individual is the
recipient of the part;
(3) an eye bank
or tissue bank.
(b) If an
anatomical gift to an individual under subdivision (a)(2) cannot be
transplanted
into the individual, the part passes in
accordance with subsection (g) in the absence of a known,
express, contrary indication by the person
making the anatomical gift.
(c) If an
anatomical gift of one or more specific parts or of all parts is made in a
document of gift that does not name a person
described in subsection (a) but identifies the
purpose for which an anatomical gift may be
used, the following rules apply:
(1) If the part
is an eye and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate eye bank.
(2) If the part
is tissue and the gift is for the purpose of transplantation or therapy, the
gift
passes to the appropriate tissue bank.
(3) If the part
is an organ and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate organ procurement
organization as custodian of the organ.
(4) If the part
is an organ, an eye, or tissue and the gift is for the purpose of research or
education, the gift passes to the appropriate
procurement organization.
(d) For the
purpose of subsection (c), if there is more than one purpose of an anatomical
gift set forth in the document of gift but the
purposes are not set forth in any priority, the gift must
be used for transplantation or therapy, if
suitable. If the gift cannot be used for transplantation or
therapy, the gift may be used for research or
education.
(e) If an
anatomical gift of one or more specific parts is made in a document of gift
that
does not name a person described in subsection
(a) and does not identify the purpose of the gift,
the gift passes in accordance with subsection
(g) and must be used for transplantation or therapy,
if suitable. If the gift cannot be used for
transplantation or therapy, the gift may be used for
research or education.
(f) If a
document of gift specifies only a general intent to make an anatomical gift by
words such as “donor”, “organ donor”, or “body
donor”, or by a symbol or statement of similar
import, the gift passes in accordance with
subsection (g) and must be used for transplantation or
therapy, if suitable. If the gift cannot be used
for transplantation or therapy, the gift may be used
for research or education.
(g) For
purposes of subsections (b), (e), and (f) the following rules apply:
(1) If the part
is an eye, the gift passes to the appropriate eye bank.
(2) If the part
is tissue, the gift passes to the appropriate tissue bank.
(3) If the part
is an organ, the gift passes to the appropriate organ procurement
organization as custodian of the organ.
(h) An
anatomical gift of an organ for transplantation or therapy, other than an
anatomical gift under subdivision (a)(2), passes
to the organ procurement organization as
custodian of the organ.
(i) If an
anatomical gift does not pass pursuant to subsections (a) through (h) or the
decedent’s body or part is not used for
transplantation, therapy, research, or education, custody of
the body or part passes to the person under
obligation to dispose of the body or part.
(j) A person
may not accept an anatomical gift if the person knows that the gift was not
effectively made in accordance with this chapter
or if the person knows that the decedent made a
refusal in accordance with this chapter that was
not revoked. For purposes of the subsection, if a
person knows that an anatomical gift was made on
a document of gift, the person is deemed to
know of any amendment or revocation of the gift
or any refusal to make an anatomical gift on the
same document of gift.
(k) Except as
otherwise provided in subdivision (a)(2), nothing in this chapter affects the
allocation of organs for transplantation or
therapy.
23-18.6.1-12.
Search and notification. -- (a) The following persons shall make a
reasonable search of an individual who the
person reasonably believes is dead or near death for a
document of gift or other information identifying
the individual as a donor or as an individual
who made a refusal:
(1) a law
enforcement officer, firefighter, paramedic, or other emergency rescuer finding
the individual; and
(2) if no other
source of the information is immediately available, a hospital, as soon as
practical after the individual’s arrival at the
hospital.
(b) If a
document of gift or a refusal to make an anatomical gift is located by the
search
required by subdivision (a)(1) and the
individual or deceased individual to whom it relates is
taken to a hospital, the person responsible for
conducting the search shall send the document of
gift or refusal to the hospital.
(c) A person is
not subject to criminal or civil liability for failing to discharge the duties
imposed by this section but may be subject to
administrative sanctions.
23-18.6.1-13.
Delivery of document of gift not required – Right to examine. -- (a) A
document of gift need not be delivered during the
donor’s lifetime to be effective.
(b) Upon or
after an individual’s death, a person in possession of a document of gift or a
refusal to make an anatomical gift with respect
to the individual shall allow examination and
copying of the document of gift or refusal by a
person authorized to make or object to the making
of an anatomical gift with respect to the
individual or by a person to which the gift could pass
pursuant to the provisions of this chapter.
23-18.6.1-14.
Rights and duties of procurement organization and others. -- (a) When
a hospital refers an individual at or near death
to a procurement organization, the organization
shall make a reasonable search of the records of
the department of motor vehicles and any donor
registry that it knows exists for the
geographical area in which the individual resides to ascertain
whether the individual has made an anatomical
gift.
(b) A
procurement organization must be allowed reasonable access to information in
the
records of the Rhode Island Donor Registry to
ascertain whether an individual at or near death is
a donor.
(c) When a
hospital refers an individual at or near death to a procurement organization,
the organization may conduct any reasonable examination
necessary to assess the medical
suitability of a part that is or could be the
subject of an anatomical gift for transplantation,
therapy, research, or education from a donor or
a prospective donor. During the examination
period, measures necessary to maintain the
potential medical suitability of the part may not be
withdrawn unless the hospital or procurement
organization knows that the individual expressed a
contrary intent.
(d) Unless
otherwise prohibited, at any time after a donor’s death, the person to which a
part passes under this chapter may conduct any
reasonable examination necessary to assess the
medical suitability of the body or part for its
intended purpose.
(e) Unless
otherwise prohibited, an examination under subsection (c) or (d) may include
an examination of all medical and dental records
of the donor or prospective donor.
(f) Upon the
death of a minor who was a donor or had signed a refusal, unless a
procurement organization knows the minor is
emancipated, the procurement organization shall
conduct a reasonable search for the parents of
the minor and provide the parents with an
opportunity to revoke or amend the anatomical
gift or revoke the refusal.
(g) Upon
referral by a hospital under subsection (a), a procurement organization shall
make a reasonable search for any person listed
in section 23-18.6.1-9 having priority to make an
anatomical gift on behalf of a prospective
donor. If a procurement organization receives
information that an anatomical gift to any other
person was made, amended, or revoked, it shall
promptly advise the other person of all relevant
information.
(h) Subject to
the provisions of this chapter, the rights of the person to which a part
passes under section 23-18.6.1-11 are superior
to the rights of all others with respect to the part.
The person may accept or reject an anatomical
gift in whole or in part. Subject to the terms of the
document of gift as specified in this chapter, a
person that accepts an anatomical gift of an entire
body may allow embalming, burial or cremation,
and use of remains in a funeral service. If the
gift is of a part, the person to which the part
passes under section 23-18.6.1-11, upon the death of
the donor and before embalming, burial, or
cremation, shall cause the part to be removed without
unnecessary mutilation.
(i) Neither the
physician who attends the decedent at death nor the physician who
determines the time of the decedent’s death may participate
in the procedures for removing or
transplanting a part from the decedent.
(j) A physician
or technician may remove a donated part from the body of a donor that
the physician or technician is qualified to
remove.
23-18.6.1-15.
Coordination of procurement and use. -- Each hospital in this state
shall
enter into agreements or affiliations with
procurement organizations for coordination of
procurement and use of anatomical gifts.
23-18.6.1-16.
Sale or purchase of parts prohibited. -- (a) Except as otherwise
provided
in subsection (b), a person that for valuable
consideration, knowingly purchases or sells a part for
transplantation or therapy if removal of a part
from an individual is intended to occur after the
individual’s death commits a felony and upon
conviction is subject to a fine not exceeding fifty
thousand dollars ($50,000) or imprisonment not
exceeding five (five) years, or both.
(b) A person
may charge a reasonable amount for the removal, processing, preservation,
quality control, storage, transportation,
implantation, or disposal of a part.
23-18.6.1-17.
Other prohibited acts. -- A person that, in order to obtain a financial
gain,
intentionally falsifies, forges, conceals,
defaces, or obliterates a document of gift, an amendment
or revocation of a document of gift, or a
refusal commits a felony and upon conviction is subject
to a fine not exceeding fifty thousand dollars
($50,000) or imprisonment not exceeding five (5)
years, or both.
23-18.6.1-18.
Immunity. -- (a) A person that acts in accordance with this chapter or
with
the applicable anatomical gift law of another
state, or attempts in good faith to do so, is not liable
for the act in a civil action, criminal
prosecution, or administrative proceeding.
(b) Neither the
person making an anatomical gift nor the donor’s estate is liable for any
injury or damage that results from the making or
use of the gift.
(c) In determining
whether an anatomical gift has been made, amended, or revoked
pursuant to this chapter, a person may rely upon
representations of an individual listed in section
23-18.6.1-9 relating to the individual’s
relationship to the donor or prospective donor unless the
person knows that the representation is untrue.
23-18.6.1-19.
Law governing validity – Choice of law as to execution of document of
gift – Presumption of validity. --(a) A document
of gift is valid if executed in accordance with:
(1) this
chapter;
(2) the laws of
the state where it was executed; or
(3) the laws of
the state where the person making the anatomical gift was domiciled, has
a place of residence, or was a national at the
time the document of gift was executed.
(b) If a
document of gift is valid under this section, the law of this state governs the
interpretation of the document of gift.
(c) A person
may presume that a document of gift or amendment of an anatomical gift is
valid unless that person knows that it was not
validly executed or was revoked.
23-18.6.1-20.
Donor registry. -- (a) A donor registry must:
(1) allow a
donor or other person authorized pursuant to this chapter to include an
individual on the donor registry who has made an
anatomical gift;
(2) be
accessible to a procurement organization to allow it to obtain relevant
information
on the donor registry to determine, at or near
death of the donor or a prospective donor, whether
the donor or prospective donor has made an
anatomical gift; and
(3) be
accessible for purposes of subdivisions (1) and (2) seven days a week on a
twenty-
four (24) hour basis.
(b) Personally
identifiable information on a donor registry about a donor or prospective
donor may not be used or disclosed without the
express consent of the donor, prospective donor,
or person that made the anatomical gift for any
purpose other than to determine, at or near death
of the donor or prospective donor, whether the
donor or prospective donor has made an
anatomical gift.
23-18.6.1-21.
[reserved].
23-18.6.1-22.
Cooperation between medical examiner and procurement
organization. -- A medical examiner shall
cooperate with procurement organizations to
maximize the opportunity to recover anatomical
gifts for the purpose of transplantation, therapy,
research, or education.
23-18.6.1-23.
Facilitation of anatomical gift from decedent whose body is under
jurisdiction of medical examiner. – (a) The medical examiner
or his or her designee shall
provide the federally designated organ
procurement organization and other nonprofit federally
registered eye and tissue banks, in a timely
manner, all information necessary to facilitate organ
and tissue donation including, but not limited
to, names and available contact information of
individuals whose deaths have been reported to
the medical examiner's office and jurisdiction
accepted.
(b) The medical
examiner may release and permit the removal of a part from a body
within that official's custody, for
transplantation or therapy, if:
(1) The
official has received a request for the part from a hospital, physician,
surgeon, or
procurement organization;
(2) A donation
has been authorized in accordance with sections 23-18.6.1-5 or 23-18.6.1-
9;
(3) The
official does not know of a refusal or contrary indication by the decedent or
objection by a person having authority to act as
listed in section 23-18.6.1-9;
(4) The removal
will be by a physician, surgeon, or technician; but in the case of eyes, by
one of them or by an enucleator;
(5) The removal
will not interfere with any autopsy, investigation, procedure, or other
additional activity as deemed necessary by the
medical examiner required to arrive at a
reasonable cause and manner of death;
(6) The removal
will be in accordance with accepted medical standards; and
(7) Cosmetic
restoration will be done, if appropriate.
(c) The medical
examiner, or his or her designee, may permit the removal of the
anatomical gift to occur at the medical
examiner's office.
(d) A permanent
record of the names of the decedent, the person making the request, the
date and purpose of the request, the part
requested, and the person to whom it was released should
be made by the hospital/physician/technician
(enucleator) and forwarded to the medical examiner
for his or her records.
(e) The medical
examiner, or his or her designee, shall be present during the removal of
the anatomical gift if in his or her judgment
such attendance would, in the opinion of the medical
examiner or his or her designee, facilitate a
donation that would otherwise be denied.
(f) The medical
examiner, or his or her designee, may only deny removal of the
anatomical gift after explaining in writing or
verbally with subsequent written documentation to
the federally designated organ procurement
organization and other nonprofit federally registered
eye and tissue banks, reasons for determining
that those tissues or organs may be involved in the
cause of death.
23-18.6.1-24.
Uniformity of application and construction. -- In applying and
construing this uniform act, consideration must
be given to the need to promote uniformity of the
law with respect to its subject matter among
states that enact it.
23-18.6.1-25.
Relation to electronic signatures in global and national commerce act.
-- This act modifies, limits, and supersedes
the Electronic Signatures in Global and National
Commerce Act, 15 U.S.C. Section 7001 et seq.,
but does not modify, limit or supersede Section
101(a) of that act, 15 U.S.C. Section 7001, or
authorize electronic delivery of any of the notices
described in Section 103(b) of that act, 15
U.S.C. Section 7003(b).
SECTION 3. Section
31-10-26.1 of the General Laws in Chapter 31-10 entitled
"Operators' and Chauffeurs' Licenses"
is hereby amended to read as follows:
31-10-26.1. Anatomical
gifts by drivers. -- (a) The division of motor vehicles shall
cause to be sent to each person applying for or
renewing a license, as provided for in section 31-
10-26, a document containing a summary
description and explanation of the Revised Uniform
Anatomical Gift Act, chapter 18.6.1 of
title 23.
(b) The division
of motor vehicles may, on behalf of the state accept and deposit with the
general treasurer any grant, gift, or
contribution made to assist in meeting the cost of carrying out
the purposes of this section and to expend the
grant, gift, or contribution for those purposes.
(c) The division
of motor vehicles may make and sign any agreements and may do and
perform any and all acts which may be necessary
or desirable to carry out the purposes of this
section.
(d) The division
of motor vehicles shall issue special licenses upon request of a licensee
which conform to the provisions of the Rhode
Island Revised Uniform Anatomical Gift Act,
chapter 18.6.1 of title 23.
(e) Neither the
administrator of the division of motor vehicles nor any employee of the
state shall be liable in any suit for damages as
a result of his or her acts or omissions or for any
action under the provisions of this section.
(f) The division
of motor vehicles shall cause to be posted in all of its customer service
locations a sign or other material encouraging
persons to make anatomical gifts during the
process of issuing and renewing licenses
provided for in section 31-10.1-1 and in accordance
with the Revised Uniform Anatomical Gift
Act, chapter 18.6.1 of title 23.
(g) The division
of motor vehicles shall cause to be produced application forms and
renewal forms for driver's licenses and
nonoperator identification cards that clearly offer Rhode
Island residents the option to consent to organ and
tissue donation in accordance with section 31-
10.1-8. Only a "yes" or affirmative
response will be noted. Information held by the division of
motor vehicles regarding a person's consent to
donate shall constitute the "Rhode Island Donor
Registry." This information will be made
available to all federally designated organ procurement
organizations and law enforcement organizations
twenty-four (24) hours a day via a password
protected Internet connection and will only be
used to fulfill the donation wishes of the licensee
or card holder. Only a "yes" or
affirmative response will be noted. Information held by the
division of motor vehicles regarding a person's
consent to donate shall constitute the "Rhode
Island Donor Registry." This information
will be made available to all federally designated organ
procurement organizations and law enforcement
organizations twenty-four (24) hours a day via a
password protected Internet connection and will
only be used to fulfill the donation wishes of the
licensee or card holder facilitate
anatomical gifts in accordance with the Revised Uniform
Anatomical Gift Act, chapter 23-18.6.1.
(h) The division
of motor vehicles shall develop by January 1, 2008 a method that
requires written consent and confirmation to
allow residents of Rhode Island to have their names
accurately added to or deleted from the
division's Rhode Island Donor Registry in the periods
between mandated driver's license renewals.
Persons added to the Donor Registry in this manner
shall be considered as having made a document of
gift.
SECTION 4. This
act shall take effect upon passage.
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LC01996/SUB A/3
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