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Published: 2008-03-26

Anatomical Gifts



Legal Aspects of Anatomical Gifts

An anatomical gift is a donation of organs and tissues. Advancements in medicine have now made it possible to transplant twenty-five different human organs and tissues, including corneas, heart, liver, kidney, lungs, pancreas, bone and skin. Donations may also be used for research related to diseases, disabilities and injuries.

As the success rate of transplants continues to increase, more anatomical gifts are needed. The demand for organs and tissues far exceeds the number of those available. The Uniform Anatomical Gift Act was enacted in August, 1968 for the purpose of establishing comprehensive and uniform laws regarding organ and tissue donations. If an individual dies in a state other than that where the gift was executed, uncertainty about the applicable law is eliminated and the gift will be recognized. It was also designed to ensure compliance with the donor's wishes. All 50 states and the District of Columbia have adopted the act, with some states making minor variations.

Who May Execute an Anatomical Gift?

Any individual of sound mind who is at least 18 years of age may execute an anatomical gift, either for personal donation or on behalf of another. With consent of a parent or legal guardian, a minor may also make a gift. The execution of a gift may occur before or after death. Neither age nor medical history should affect or discourage the execution of an anatomical gift. Some donations have no age restrictions and a body of any age is valuable for research.

The execution of an anatomical gift is preferably made by the donor, with that intent conveyed to and discussed with family members. While no other individual is legally authorized to revoke a donor's execution of an anatomical gift, in reality most hospitals, physicians and organ procurement personnel rely on family or next of kin confirmation. This is done in order to avoid potential legal actions, to avoid creating additional stress for the family at the time of a relative's death, and to avoid any adverse public perceptions which may compromise organ donation programs by discouraging other potential donors. Therefore, to avoid the possibility of having a gift revoked, make certain the appropriate individuals have been informed about your commitment to your personal anatomical donation.

By statute, consent to organ and tissue donation is sought from these individuals in the following order of priority:

1. Spouse
2. Adult Child
3. Parent
4. Adult Sibling
5. Legal Guardian

If any individual in a prior category refuses consent, no organs or tissues will be taken.

Limitations on Anatomical Gifts

The execution of an anatomical gift may specify that all or part of the body may be used. This authorization also allows any examination necessary to assure the medical acceptability of the gift. If the gift is of the entire body, where appropriate, the body may be embalmed and used for funeral services prior to the donee accepting the gift. If the gift is for some parts of the entire body, these will be removed as soon as possible after death and the remainder of the body returned to the family or next of kin for disposition.

How to Execute an Anatomical Gift

An anatomical gift may be executed by so indicating on the back of your driver's license, or executing the following Uniform Donor Card:

Uniform Donor Card of
_________________________________________
(Print or type name of donor)

In the hope that I may help others, I hereby make this anatomical gift, if medically acceptable, to take effect upon my death. The words and marks below indicated my desires:

I Give
(a) __ Any needed organs or tissues.
(b) __ Only the following organs or tissue
______________________________________________________________
(Specify the organ(s) or tissue(s))
for the purposes of transplantation, therapy, medical research or education;
(c)__ My body for anatomical study, if needed.

Limitations or special wishes, if any:
___________________________________________
Signed by the donor and the following two witnesses in the presence of each other:
Signature of Donor _________________________
Date of Birth of Donor ______________________
Date Signed ________________________________
City and State ______________________________
_____________________________________________
Witness
(Preferably Next of Kin)

This is a legal document under the Uniform Anatomical Gift Act or similar laws.

If the donor is unable to personally sign, another person may be directed to sign by the donor in the presence of the two witnesses.

It is not recommended that an anatomical gift be made in a will, as it usually requires a period of time before the will is read and probated.

At any time an anatomical gift may be revoked. This may occur through any of the following methods:

1. A signed statement of the donor;
2. An oral statement made in the presence of two people;
3. A statement made during a terminal illness or injury addressed to an attending physician;
4. By destruction, mutilation or cancellation of the document; or
5. A revised signed card or document.

Potential Donees

A donor may specify any of the following to become donees of anatomical gifts for the purposes stated:

1. Any hospital, surgeon or physician, for medical or dental education, research, advancement of medical or dental science, therapy or transplantation;
2. Any accredited medical or dental school, college or university or the State Anatomical Board for education, research, advancement of medical or dental science or therapy;
3. Any bank or storage facility, for medical or dental education, research, advancement of medical or dental science, therapy or transplantation; or
4. Any specified individual for therapy or transplantation needed.

Although donees may be specified, frequently they may not be compatible with the donor and alternate donees should be considered. Such factors as blood type, body size and urgency of need must be evaluated. Organ and tissue banks function collectively to determine compatible donors and donees and prioritized needs for anatomical gifts. Therefore, final decisions regarding appropriateness of transplantation are made by those organizations.

It is also acceptable to make an anatomical gift without specifying a donee. In this instance, the gift may be accepted by the attending physician as donee upon or following death.

Pronouncement of Death

Merely executing an anatomical gift will not in any way alter the high quality care that an individual will receive prior to death. Medical personnel must follow very strict guidelines before death can be pronounced and organs and tissues are removed from a donor. The physician pronouncing or certifying death may not in any way participate in the procedures for removing or transplanting anatomical gifts or be a relative within the fourth degree of consanguinity of the recipient donee of the anatomical gifts.

Responsibility of Hospitals Regarding Anatomical Gifts

In June 1986, Missouri enacted a law entitled "Required Request," giving every individual the right to be offered the opportunity of organ and tissue donations. This law also requires hospitals to designate an individual within the institution to request anatomical gifts when there is a patient who is a suitable candidate. However, no request is required if the hospital designee has actual notice of contrary indications by the donor or family member. The hospital has the responsibility for notifying the organ or tissue procurement organization and to provide the necessary assistance to procure any anatomical gifts.

Conclusion

The execution of an anatomical gift is a gift of life. It can be the ultimate fulfillment of one's own life. Spending a few minutes now executing an anatomical gift and discussing it with family members can ensure compliance with an intended gift.

If you have additional questions regarding the legal aspects of organ and tissue donation, consult your attorney.

For Legal Advice See Your Lawyer

If you need help finding a lawyer, call The Missouri Bar Lawyer Referral Service at 573/636-3635.

In St. Louis call 314/622-4995
In Kansas City call 816/221-9472
In Greene County call 417/831-2783


The Missouri Bar, P.O. Box 119, Jefferson City, MO 65102-0119