2003 -- S 0442 SUBSTITUTE A

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LC00309/SUB A/2

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2003

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A N A C T

RELATING TO ANATOMICAL GIFTS BY MOTOR VEHICLE OPERATORS

     Introduced By: Senator Leo R. Blais

     Date Introduced: February 13, 2003

     Referred To: Senate Health & Human Services

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 31-10-26.1 of the General Laws in Chapter 31-10 entitled

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"Anatomical Gifts by Drivers" is hereby amended to read as follows:

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     31-10-26.1. Anatomical gifts by drivers. -- (a) The division of motor vehicles shall

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cause to be sent to each person applying for or renewing a license, as provided for in section 31-

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10-26, a document containing a summary description and explanation of the Anatomical Gift Act,

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chapter 18.6 of title 23, and a donor card suitable for use by a person wishing to donate tissue or

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organs pursuant to the applicable provisions of chapter 18.6 of title 23. The donor card shall

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include the definition of qualified donee, as specified in chapter 18.6 of title 23.

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      (b) The division of motor vehicles may, on behalf of the state accept and deposit with the

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general treasurer any grant, gift, or contribution made to assist in meeting the cost of carrying out

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the purposes of this section and to expend the grant, gift, or contribution for those purposes.

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      (c) The division of motor vehicles may make and sign any agreements and may do and

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perform any and all acts which may be necessary or desirable to carry out the purposes of this

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section.

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      (d) The division of motor vehicles shall issue special licenses upon request of a licensee

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which conform to the provisions of the Rhode Island Anatomical Gift Act, chapter 18.6 of title

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23.

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      (e) Neither the administrator of the division of motor vehicles nor any employee of the

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state shall be liable in any suit for damages as a result of his or her acts or omissions or for any

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action under the provisions of this section.

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      (f) The division of motor vehicles shall cause to be posted in all of its customer service

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locations a sign or other material encouraging persons to make anatomical gifts during the

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process of issuing and renewing licenses provided for in section 31-10.1-1 and in accordance with

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the Anatomical Gift Act, chapter 18.6 of title 23. denoting that organ donor cards are available,

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from a division of motor vehicles customer service representative, upon request from a person

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applying for or renewing a license. Organ donor cards shall be placed in areas visible to

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customers.

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     (g) The division of motor vehicles shall cause to be produced application forms and

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renewal forms for driver's licenses and nonoperator identification cards that clearly offer Rhode

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Island residents the option to consent to organ donation in accordance with section 31-10.1-8.

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      (g) When obtaining or renewing the driver's license, Rhode Island residents, who request

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an organ donor card, may be asked this question: "Do you wish to have the organ donor

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designation on your driver's license?" If the driver says "yes", that information will be designated

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on the license. When obtaining or renewing the driver's license, Rhode Island residents, who

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request an organ donor card, will be asked this question: "Do you wish to have the organ donor

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designation printed on your driver's license?" If the driver says "yes", that information will be

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designated on the license and the information made a permanent part of the driver's record with

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the Rhode Island division of motor vehicles. Only a "yes" or affirmative response will be noted.

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This information will be made available to all law enforcement organizations twenty-four (24)

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hours a day and will be used to notify next of kin of their family member's affirmative response to

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organ donation. Information held by the division of motor vehicles regarding a person's consent

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to donate shall constitute the "Rhode Island Donor Registry." This information will be made

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available to all federally designated organ procurement organizations and law enforcement

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organizations twenty-four (24) hours a day via a password protected Internet connection and will

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only be used to fulfill the donation wishes of the licensee or card holder.

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     (h) The division of motor vehicles shall develop a method that requires written consent

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and confirmation to allow residents of Rhode Island to have their names accurately added to or

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deleted from the division's Rhode Island Donor Registry in the periods between mandated driver's

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license renewals. Persons added to the Donor Registry in this manner shall be considered as

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having made a document of gift.

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     SECTION 2. Section 31-10.1-8 of the General Laws in Chapter 31-10.1 entitled "Special

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License for Motorcycles, Motor Scooters, and Other Motor Driven Cycles" is hereby amended to

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read as follows:

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     31-10.1-8. Anatomical gifts by operators. -- (a) The division of motor vehicles, in

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conjunction with the federally designated organ and tissue procurement agency, shall develop and

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implement a program encouraging and allowing for persons to make anatomical gifts, during the

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process of issuing and renewing licenses provided for in section 31-10.1-1. The division of motor

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vehicles shall give to all persons seeking the licenses, a document containing a summary

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description and explanation of the Anatomical Gift Act, chapter 18.6 of title 23. Any person

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wishing to donate tissue or organs under the provisions of chapter 18.6 of title 23 shall be

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included in the Rhode Island Donor Registry as defined by section 31-10-26.1(g) and issued a

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driver's license or nonoperator's identification card bearing a notation or symbol indicating the

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person's consent to donate issued a donor card suitable for use under the chapter and defining the

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term "qualified donee" as outlined in chapter 18.6 of title 23. The division of motor vehicles, in

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conjunction with the federally designated organ and tissue procurement agency, may on behalf of

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the state, accept and deposit with the general treasurer any grant, gift or contribution made to

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assist in meeting the cost of carrying out the purposes of this section, and may expend the funds

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for these purposes.

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      (b) Application for monies to support these purposes will be made to the general

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treasurer by the division of motor vehicles, and/or the federally designated organ and tissue

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procurement agency.

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      (c) The division of motor vehicles may make and sign any agreements and may do and

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perform any and all acts necessary to carry out the purposes of this section.

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     SECTION 3. Sections 23-18.6-1, 23-18.6-2, 23-18.6-3 and 23-18.6-4 of the General

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Laws in Chapter 23-18.6 entitled "Uniform Anatomical Gift Act" are hereby amended to read as

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follows:

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     23-18.6-1. Definitions. -- As used in this chapter:

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      (1) "Anatomical gift" means a donation of all or part of a human body to take effect upon

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or after death.

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      (2) "Decedent" means a deceased individual and includes a stillborn infant or fetus.

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      (3) "Document of gift" means a card, a statement or symbol attached to or imprinted on a

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motor vehicle operator's or chauffeur's license, inclusion in the Rhode Island Donor Registry, a

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will, or other writing used to make an anatomical gift.

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      (4) "Donor" means an individual who makes an anatomical gift of all or part of the

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individual's body.

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      (5) "Enucleator" means an individual who is licensed or certified by the state board of

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medical examiners and/or department of health and/or federally designated eye procurement

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organization to remove or process eyes or parts of eyes.

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      (6) "Hospital" means a facility licensed, accredited, or approved as a hospital under the

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law of any state or a facility operated as a hospital by the United States government, a state, or a

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subdivision of a state.

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      (7) "Part" means an organ, tissue, eye, bone, artery, blood, fluid, or other portion of a

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human body.

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      (8) "Person" means an individual, corporation, business trust, estate, trust, partnership,

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joint venture, association, government, governmental subdivision or agency, or any other legal or

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commercial entity.

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      (9) "Physician" or "surgeon" means an individual licensed or otherwise authorized to

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practice medicine and surgery or osteopathy and surgery under the laws of any state.

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      (10) "Procurement organization" means federally designated eye or organ procurement

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organization accredited, and/or approved under the laws of any state for procurement,

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distribution, or storage of human bodies or parts.

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      (11) "State" means a state, territory, or possession of the United States, the District of

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Columbia, or the Commonwealth of Puerto Rico.

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      (12) "Technician" means an individual who is licensed or certified by the State Board of

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Medical Examiners and/or department of health and/or federally designated eye procurement

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organization to remove or process eyes or parts of eyes.

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     23-18.6-2. Making, amending, revoking, and refusing to make anatomical gifts by

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individual. -- (a) An individual who is at least (18) years of age may:

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      (1) Make an anatomical gift for any of the purposes stated in section 23-18.6-6(a);

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      (2) Limit an anatomical gift to one or more of those purposes; or

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      (3) Refuse to make an anatomical gift.

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      (b) An anatomical gift may be made only by a document of gift signed by the donor or

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by indicating consent to donate under title 31 chapters 31-10 and 31-10.1. If the donor cannot

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sign, the document of gift must be signed by another individual, the next of kin, or designee and

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by two (2) witnesses, all of whom have signed at the direction and in the presence of the donor

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and of each other, and state that it has been so signed.

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      (c) If a document of gift is attached to or imprinted on a donor's motor vehicle operator's

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or chauffeur's license, the document of gift must comply with subsection (b). Revocation

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revocation, suspension, expiration, or cancellation of the license does not invalidate the

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anatomical gift.

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      (d) A document of gift may designate a particular physician or surgeon in cases of living

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relation donation and transplantation to carry out the appropriate procedures. In the absence of a

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designation or if the designee is not available, the donee or other person authorized to accept the

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anatomical gift may employ or authorize any physician, surgeon, technician, or enucleator to

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carry out the appropriate procedures.

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      (e) An anatomical gift by will takes effect upon death of the testator, whether or not the

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will is probated. If, after death, the will is declared invalid for testamentary purposes, the validity

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of the anatomical fight is unaffected.

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      (f) A donor may amend or revoke an anatomical gift, not made by will, only by:

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      (1) A signed statement;

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      (2) An oral statement made in the presence of two (2) individuals;

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      (3) Any form of communication during a terminal illness or injury addressed to a

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physician or surgeon; or

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      (4) The delivery of a signed statement to a specified donee to whom a document of gift

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had been delivered.

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      (g) The donor of an anatomical gift made by will may amend or revoke the gift in the

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manner provided for amendment or revocation of will, or as provided in subsection (f).

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      (h) An anatomical gift that is not revoked by the donor before death is irrevocable and

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does not require the consent or concurrence of any person after the donor's death., except in cases

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where the deceased is under the age of eighteen (18). In cases where the deceased is under the

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age of eighteen (18), an anatomical gift shall be made as set forth in section 23-18.6-3.

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      (i) An individual may refuse to make an anatomical gift of the individual's body or party

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part by: (1) a writing signed in the same manner as a document of gift; (2) a statement attached to

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or imprinted on a donor's motor vehicle operator's or chauffeur's license; or (3) any other writing

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used to identify the individual as refusing to make an anatomical gift. During a terminal illness or

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injury, the refusal may be an oral statement or other form of communication.

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      (j) In the absence of contrary indications by the donor, an anatomical gift of a part is

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neither a refusal to give other parts nor a limitation on an anatomical gift under section 23-18.6-3

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or on a removal or release of other parts under section 23-18.6-4.

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      (k) In the absence of contrary indications by the donor, a revocation or amendment of an

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anatomical gift is not a refusal to make another anatomical gift. If the donor intends a revocation

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to be a refusal to make an anatomical gift, the donor shall make the refusal pursuant to subsection

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(i).

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     23-18.6-3. Making, revoking, and objecting to anatomical gifts by others Making,

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revoking, and objecting to anatomical gifts by persons other than the donor. -- (a) Any

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member of the following classes of persons, in the order of priority listed, may make an

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anatomical gift of all or a part of the decedent's body for an authorized purpose, unless the

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decedent, at the time of death, has made an unrevoked refusal to make that anatomical gift:

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      (1) The spouse of the decedent;

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      (2) An adult son or daughter of the decedent;

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      (3) Either parent of the decedent;

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      (4) An adult brother or sister of the decedent;

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      (5) A grandparent of the decedent; and

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      (6) A guardian of the person of the decedent at the time of death.

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      (b) An anatomical gift may not be made by a person listed in subsection (a) if:

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      (1) A person in a prior class is available at the time of death to make an anatomical gift;

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      (2)(i) The person proposing to make an anatomical gift knows of a written refusal or

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written contrary indications by the decedent, provided that the decedent has signed a document of

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gift; or

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     (ii) If the decedent has not signed a document of gift, and if the person proposing to make

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an anatomical gift knows of any refusal or any contrary indications by the decedent; or

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      (3) The person proposing to make an anatomical gift knows of an objection to making an

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anatomical gift by a member of the person's same class or a prior class.

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      (c) An anatomical gift by a person authorized under subsection (a) must be made by:

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      (1) A document of gifts signed by the person or

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      (2) The person's telegraphic, recorded telephonic, or other recorded message, or other

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form of communication from the person that is contemporaneously reduced to writing and signed

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by the recipient.

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      (d) An anatomical gift by a person authorized under subsection (a) may be revoked by

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any member of the same or a prior class before procedures have begun for the removal from the

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body of the decedent, the physician, surgeon, technician, or enucleator removing the part.

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      (e) A failure to make an anatomical gift under subsection (a) is not an objection to the

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making of an anatomical gift.

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     23-18.6-4. Authorization by medical examiner. -- (a) The medical examiner may

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release and permit the removal of a part from a body within that official's custody, for

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transplantation or therapy, if:

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      (1) The official has received a request for the part from a hospital, physician, surgeon, or

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procurement organization;

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      (2) The hospital staff "transplant team" has made a reasonable effort, taking into account

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the useful life of the part, to locate and examine the decedent's medical records and inform

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persons listed in section 23-18.6-3(a) of their option to make, or object to making, an anatomical

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gift;

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      (3) The official does not know of a refusal or contrary indication by the decedent or

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objection by a person having priority to act as listed in section 23-18.6-3(a);

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      (4) The removal will be by a physician, surgeon, or technician; but in the case of eyes,

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by one of them or by an enucleator;

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      (5) The removal will not interfere with any autopsy, investigation, procedure, or other

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additional activity as deemed necessary by the medical examiner to arrive at a reasonable cause

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and manner of death;

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      (6) The removal will be in accordance with accepted medical standards; and

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      (7) Cosmetic restoration will be done, if appropriate.

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      (b) A permanent record of the names of the decedent, the person making the request, the

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date and purpose of the request, the part requested, and the person to whom it was released should

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be made by the hospital/physician/technician (enucleator) and forwarded to the medical examiner

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for his or her records.

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     (c) The medical examiner, or his or her designee, shall be present during the removal of

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the anatomical gift if in his or her judgment such attendance would, in the opinion of the medical

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examiner or his or her designee, facilitate a donation that would otherwise be denied.

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     (d) The medical examiner, or his or her designee, may only deny removal of the

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anatomical gift after explaining in writing reasons for determining that those tissues or organs

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may be involved in the cause of death.

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     SECTION 4. This act shall take effect on January 1, 2004.

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LC00309/SUB A/2

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO ANATOMICAL GIFTS BY MOTOR VEHICLE OPERATORS

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     This act would require the division of motor vehicles to provide materials encouraging

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persons to become organ or tissue donors.

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     This act would take effect on January 1, 2004.

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LC00309/SUB A/2

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