157.06(2)(c)1.1. Before January 1, 1991, if a document of gift is attached to or imprinted on the donor's license to operate a motor vehicle or identification card issued by the department of transportation, the document of gift shall comply with
par. (b) and
s. 343.17 or
343.50. Revocation, suspension, expiration or cancellation of the license or identification card does not invalidate the anatomical gift.
157.06(2)(c)2.
2. After December 31, 1990, if a document of gift is attached to or imprinted on the donor's license under
s. 343.175 (2) or identification card under
s. 343.50 (3) issued by the department of transportation, the document of gift shall comply with
par. (b) and
s. 343.175 or
343.50. Revocation, suspension, expiration or cancellation of the license or identification card does not invalidate the anatomical gift.
157.06(2)(d)
(d) A document of gift may designate a particular physician 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, technician or enucleator to carry out the appropriate procedures.
157.06(2)(e)
(e) An anatomical gift under the circumstances in which the document of gift is by will takes effect upon death of the testator, whether or not the will is probated. If after the death of the testator the will is declared invalid for testamentary purposes, the validity of the anatomical gift is unaffected.
157.06(2)(f)
(f) A donor may amend or revoke an anatomical gift or a refusal to make an anatomical gift under
par. (i) by doing any of the following:
157.06(2)(f)1m.
1m. Signing a new document of gift. Signing a new document of gift revokes any previously signed document of gift.
157.06(2)(f)2.
2. Verbally amending or revoking in the presence of 2 individuals.
157.06(2)(f)3.
3. During the donor's terminal illness or injury making, by any form of communication that is addressed to a physician, an amendment or revocation.
157.06(2)(f)4.
4. Delivering a signed statement of amendment or revocation to a specified donee to whom a document of gift had been delivered.
157.06(2)(f)5.
5. Crossing out or amending the donor authorization or refusal in the space provided on his or her license as prescribed in
s. 343.175 (2) or identification card as prescribed in
s. 343.50 (3).
157.06(2)(f)6.
6. Revoking the provision of a power of attorney for health care instrument that makes an anatomical gift or revoking that power of attorney for health care instrument.
157.06(2)(g)
(g) In addition to the means specified in
par. (f), an anatomical gift made by will may be amended or revoked in the manner provided for amendment or revocation of wills.
157.06(2)(h)
(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.
157.06(2)(i)
(i) An individual may refuse to make an anatomical gift of the individual's body or part of his or her body by doing any of the following:
157.06(2)(i)1.
1. Making a writing of refusal that is signed in the same manner as is required for a document of gift.
157.06(2)(i)2.
2. Attaching a statement of refusal to or imprinting a statement of refusal on his or her license under
s. 343.175 (2) or identification card under
s. 343.50 (3).
157.06(2)(i)3.
3. Making any other writing that is used to identify the individual as refusing to make an anatomical gift. During the individual's terminal illness or injury, he or she may make the refusal by an oral statement or other form of communication to another.
157.06(2)(j)
(j) In the absence of contrary indications by the donor, an anatomical gift of a part of a human body is neither a refusal to give other parts of the body nor a limitation on an anatomical gift under
sub. (3) or on a removal or release of other parts of the body under
sub. (4),
(4m), or
(4r).
157.06(2)(k)
(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 under
par. (i).
157.06(3)
(3) Making, revoking and objecting to anatomical gifts, by persons other than the donor. 157.06(3)(a)(a) Any member of the following classes of individuals, in the order of priority listed, may make an anatomical gift of all or a part of a decedent's body for a purpose specified in
sub. (6) (a), unless the decedent, at the time of death, has made an unrevoked refusal to make that anatomical gift:
157.06(3)(a)6.
6. A guardian of the person of the decedent at the time of death.
157.06(3)(b)
(b) An anatomical gift may not be made by an individual listed in
par. (a) if any of the following applies:
157.06(3)(b)1.
1. An individual in a prior class is available at the time of death to make an anatomical gift and that individual objects to the making of an anatomical gift.
157.06(3)(b)2.
2. The individual proposing to make an anatomical gift knows of a refusal or contrary indications by the decedent.
157.06(3)(b)3.
3. The individual proposing to make an anatomical gift knows of an objection to making an anatomical gift by a member of the individual's class or a prior class.
157.06(3)(c)
(c) An individual authorized under
par. (a) shall make an anatomical gift of all or a part of the decedent's body by doing one of the following:
157.06(3)(c)1.
1. Subject to
sub. (6m), if applicable, executing a document of gift that is signed by the individual.
157.06(3)(c)2.
2. Subject to
sub. (6m), if applicable, making a recorded telephonic or other recorded message, or other form of communication, to another that is reduced to writing and signed by the recipient at the time it is received. In the instance of a recorded message in which a hospital, organ procurement organization, tissue bank, coroner, or medical examiner is requesting an anatomical gift, the hospital, organ procurement organization, tissue bank, coroner, or medical examiner shall do all of the following:
157.06(3)(c)2.a.
a. Inform the individual that the conversation is recorded and that a recorded copy of the conversation is available upon request and, if requested, provide such a copy.
157.06(3)(c)2.c.
c. Note on the request form that the individual has been read the sentences required under
sub. (6m) (a) and note any limitations that the individual imposes on the use of the bones or tissues or the types of organizations that recover, process, or distribute the donation. If the procedure under this subdivision is followed, the individual's signature or initials, as specified in
sub. (6m) (b), are not required.
157.06(3)(d)
(d) Any member of the same class as or a prior class to an individual authorized under
par. (a) who has made an anatomical gift under
par. (a) may revoke the gift if, before procedures have begun for the removal of a part from the body of the decedent, the member so informs the physician or enucleator who will remove the part of the revocation.
157.06(3)(e)
(e) A failure to make an anatomical gift under
par. (a) is not an objection to the making of an anatomical gift unless the failure is accompanied by an objection to the making of an anatomical gift.
157.06(4)
(4) Authorization by coroner or medical examiner; no evidence of anatomical gift. 157.06(4)(ag)(ag) If a decedent is within the custody of a coroner or medical examiner and if there is no evidence that the decedent has made or refused to make an anatomical gift, the coroner or medical examiner shall contact by telephone the organ procurement organization designated for the region in which the death occurs. The coroner or medical examiner shall provide the organ procurement organization with information, if known to the coroner or medical examiner, concerning the decedent's age, the cause of the decedent's death and, if available, the decedent's medical history.
157.06(4)(am)
(am) The coroner or medical examiner may release and permit the removal of a part from, a decedent specified in
par. (ag) within that official's custody, for transplantation or therapy, including to a tissue bank under the requirements of
sub. (4r), if all of the following apply:
157.06(4)(am)1.
1. The official has received a request for the part of the body from a hospital, physician or organ procurement organization.
157.06(4)(am)2.
2. The official has made a reasonable effort, taking into account the useful life of the part of the body, to locate and examine the decedent's medical records and, subject to
sub. (6m), inform individuals listed in
sub. (3) (a) of their option to make, or object to making, an anatomical gift.
157.06(4)(am)3.
3. The official does not know of a refusal or contrary indication by the decedent or of an objection by an individual having priority to act as listed in
sub. (3) (a).
157.06(4)(am)4.
4. The removal will be by a physician, except for the following:
157.06(4)(am)4.a.
a. In the case of eyes, the removal may be by a physician or by an enucleator.
157.06(4)(am)4.b.
b. In the case of tissue or bone, the removal may be by a physician or by a technician.
157.06(4)(am)5.
5. The removal will not interfere with any autopsy or investigation.
157.06(4)(am)6.
6. The removal will be in accordance with accepted medical standards.
157.06(4)(am)7.
7. Cosmetic restoration will be done to the decedent's body, if appropriate.
157.06(4)(b)
(b) A coroner or medical examiner who releases, and permits the removal of a part of, a human body under this subsection shall maintain a permanent record of the name of the decedent, the name of the person making the request, the date and purpose of the request, the part of the body requested, and the name of the person to whom it was released.
157.06(4m)
(4m) Authorization by coroner or medical examiner; potential donations of organs and tissue. 157.06(4m)(a)(a) Subject to
par. (b), for a decedent who meets the criteria for a determination of death under
s. 146.71, who is a donor or of whom an anatomical gift has been made under
sub. (3), and who is within the jurisdiction of a coroner or medical examiner under
ch. 979, any vascularized organ that is an anatomical gift may be removed by a physician, within a time period compatible with preservation of the organ for purposes of transplantation, if all of the following take place:
157.06(4m)(a)1.
1. Immediately after the hospital in which the donor, potential decedent, or decedent is located contacts the organ procurement organization designated for the region of which the hospital is a part concerning the potential donation, the organ procurement organization shall, by oral conversation, provide notice to the coroner or medical examiner or his or her designee of the referral of the donor, potential decedent, or decedent and shall provide notice of the referral to the district attorney or his or her designee.
157.06(4m)(a)2.
2. The coroner or medical examiner or his or her designee has the opportunity to be present during the scheduled removal of the vascularized organ if, in the judgment of the coroner, medical examiner, or designee, the organ may be necessary in determining the cause of death.
157.06(4m)(b)
(b) If, in the judgment of the coroner, medical examiner, or designee specified in
par. (a) the vascularized organ may be necessary in determining the cause of death, the coroner, medical examiner, or designee may order a biopsy of the vascularized organ or, if the coroner, medical examiner, or designee is present during the scheduled removal, he or she may deny removal of the vascularized organ. If denial of removal is a possibility, the organ procurement organization shall make a good-faith effort to consult with a forensic pathologist designated by the coroner, medical examiner, or designee as to the pathologist's opinion concerning the necessity of the vascularized organ in determining the cause of death. If the biopsy is ordered or the removal is denied, the coroner, medical examiner, or designee shall specify, in writing as part of any death report required under
ch. 979, any reasons for determining that the vascularized organ may be involved in the cause of death.
157.06(4m)(c)
(c) For a decedent specified under
par. (a), as authorized under the requirements of this section by the coroner, medical examiner, or designee with jurisdiction over the decedent, any part other than a vascularized organ that is an anatomical gift may be removed by a physician and any part that is tissue or bone may be removed by a technician or tissue bank employee, within a time period compatible with preservation of the part for purposes of transplantation.
157.06(4m)(d)
(d) A physician, technician, or tissue bank employee who removes cardiovascular tissue from a decedent under this subsection shall, upon request of the coroner or medical examiner, file with the coroner or medical examiner with jurisdiction over the decedent a report detailing the condition of the cardiovascular tissue and its relationship to the cause of death. The report may include a biopsy or medically approved sample, if available, from the part.
157.06(4m)(e)1.1. A physician who removes an organ from a decedent under this subsection shall complete a form, as specified in
sub. (9m) (a).
157.06(4m)(e)2.
2. A physician, technician, or tissue bank employee who removes tissue, other than cardiovascular tissue, from a decedent under this subsection shall complete a form, as specified in
sub. (9m) (b).
157.06(4m)(e)3.
3. After completing a form under this paragraph, the physician, technician, or tissue bank employee shall transmit the form to the coroner or medical examiner with jurisdiction over the decedent.
157.06(4r)
(4r) Authorization by coroner or medical examiner; tissue banks. 157.06(4r)(a)1.1. If a decedent is within the custody of a coroner or medical examiner, and the death occurred in a hospital, any release of the decedent for potential donation of tissue shall be to the tissue bank with which the hospital has an agreement under
42 CFR 482.45 (a) (2). However, if such a tissue bank is unwilling to receive the tissue donation, the tissue bank shall so notify the coroner or medical examiner.
157.06(4r)(a)2.
2. Upon receipt of a notification under
subd. 1., the coroner or medical examiner may notify any other tissue bank with which the coroner or medical examiner has an agreement under
par. (b) of the availability of the decedent as a potential tissue donor.
157.06(4r)(a)3.
3. Upon receipt of a notification under
subd. 2., the tissue bank so notified, if willing to receive the tissue donation, shall contact an available individual, under the priority established in
sub. (3) (a), to request that the individual make an anatomical gift of all or a part of the decedent's tissue.
157.06(4r)(a)4.
4. If the coroner or medical examiner informs the hospital that
subds. 2. and
3. apply and that consent has been given for an anatomical gift, the hospital shall transfer the decedent to the coroner or medical examiner.
157.06(4r)(b)
(b) When a decedent is within the custody of a coroner or medical examiner, the death occurred outside a hospital or the decedent was transferred to the coroner or medical examiner under
par. (a) 4., and the coroner or medical examiner refers the decedent as a potential tissue donor, any such referral shall be made under the following conditions:
157.06(4r)(b)1.
1. Subject to
subds. 2.,
3., and
4., the coroner or medical examiner, after considering a tissue bank's history, services, traditional referral patterns, geographic service area, and tissue distribution record and any other criteria required for consideration by the corporation counsel of the applicable county, enters into a written, general referral agreement with one or more tissue banks to which the coroner or medical examiner shall refer decedents for potential donation of tissue.
157.06(4r)(b)2.
2. Any agreement under
subd. 1. is subject to review and approval by all of the the following:
157.06(4r)(b)2.b.
b. The county board of the applicable county. Within 60 days after any approval by the corporation counsel and transmittal of the agreement to the county board, the county board may approve or disapprove the agreement. If the county board takes no action, the agreement is approved.
157.06(4r)(b)3.
3. A tissue bank under this paragraph is accredited by the American Association of Tissue Banks or audited at least once every 2 years by an organization that is accredited by the American Association of Tissue Banks.
157.06(4r)(b)4.
4. All of the following applies to an agreement by a coroner or medical examiner with one or more tissue banks to which the coroner or medical examiner refers decedents for potential donation of tissue:
157.06(4r)(b)4.a.
a. Any such agreement that is entered into after April 13, 2006, shall conform to the requirements of
subds. 1. to
3.
157.06(4r)(b)4.b.
b. Any such agreement that exists on April 13, 2006, shall conform to the requirements of
subds. 1. to
3. by October 1, 2007, unless the agreement expires before that date and is not renegotiated or renewed under
subd. 4. a.
157.06(5)
(5) Policies; organ procurement organization notification; required request; search and notification. 157.06(5)(a)(a) Each hospital shall develop and adopt written policies for providing information to individuals on how to become part donors and shall make available to individuals informational brochures that discuss donation of parts.
157.06(5)(b)1.1. If at or near the time of death of a patient there is no medical record or evidence obtained under
par. (c) that the patient has made, revoked or refused to make an anatomical gift, the hospital administrator or a representative designated by the administrator shall discuss with an available individual, under the priority established in
sub. (3) (a), the option to make or refuse to make an anatomical gift and request, subject to
sub. (6m), that the individual make an anatomical gift of all or a part of the decedent's body. Alternatively, the administrator shall contact by telephone the organ procurement organization designated for the region of which the hospital is a part. If the administrator or representative contacts the organ procurement organization, he or she shall provide the organ procurement organization with the identifier number of the patient, the patient's age, the actual or potential cause of the patient's death and, if available, the patient's medical history.
157.06(5)(b)2.
2. If the organ procurement organization is contacted under
subd. 1., the organ procurement organization shall, in consultation with the attending physician of the patient under
subd. 1., determine if an anatomical gift is suitable, based upon accepted medical standards, for a purpose specified in
sub. (6) (a). If the organ procurement organization and the patient's attending physician determine that an anatomical gift is not so suitable, hospital personnel shall make a notation to this effect in the patient's medical record. If the organ procurement organization and the patient's attending physician determine that an anatomical gift is so suitable, an organ procurement organization representative or a requester designated by the organ procurement organization shall discuss with an available individual, under the priority established in
sub. (3) (a), the option to make or refuse to make an anatomical gift and request, subject to
sub. (6m), that the individual make an anatomical gift of all or a part of the decedent's body.
157.06(5)(b)3.
3. The hospital administrator or representative or the organ procurement organization representative or designated requester shall make the request with reasonable discretion and sensitivity to the circumstances of the family. A request need not be made if the gift is not suitable, based upon accepted medical standards, for a purpose specified in
sub. (6) (a) or if the requester knows that the patient, or the member of the class of individuals to whom the request would be directed under
sub. (3) (a), has a cultural or religious objection or any other objection to the making of an anatomical gift. An entry shall be made in the medical record of the patient, in accordance with the rules promulgated under
par. (f), stating the name and affiliation of the individual making the request and the name, response and relationship to the patient of the individual to whom the request was made.
157.06(5)(bm)
(bm) If at or near the time of death of a patient a hospital knows that an anatomical gift of all or a part of the patient's body has been made under
sub. (3) (a), that a release and removal of a part of the patient's body has been permitted under
sub. (4) or
(4m) or that a patient or an individual identified as in transit to the hospital is a donor, the hospital shall notify the donee if one is named and known to the hospital. If a donee is neither named nor known to the hospital, the hospital shall notify an appropriate procurement organization. The hospital shall cooperate in the implementation of the anatomical gift or release and removal of a part of the body of the patient or individual.
157.06(5)(c)
(c) All of the following persons, under the following circumstances, shall make a reasonable search for a document of gift or other information identifying the individual as a donor or as an individual who has revoked or refused to make an anatomical gift:
