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:
157.06(5)(c)1.
1. A law enforcement officer, fire fighter, emergency medical technician - paramedic, ambulance service provider or emergency medical technician - basic who finds an individual whom the person believes is dead or near death.
157.06(5)(c)2.
2. A hospital, upon the admission of an individual who is at or near the time of death, if there is not immediately available any other source of that information.
157.06(5)(d)
(d) If a document of gift, revocation of a document of gift or evidence of refusal to make an anatomical gift is located by the search required by
par. (c) 1. and the individual or decedent to whom it relates is taken to a hospital, the hospital shall be notified of the contents and the person locating the document, revocation or other evidence shall send it to the hospital.
157.06(5)(f)
(f) The department of health and family services shall promulgate rules that do all of the following:
157.06(5)(f)1.
1. Set forth policies and procedures to be followed for discussing the anatomical gift donation process with members of the patient's family in situations under
par. (b) 2. and
3. in which there is or is not a document of gift.
157.06(5)(f)2.
2. Prescribe the manner in which information obtained under
par. (b) 2. and
3. regarding anatomical gift donations, revocations and refusals shall be placed in the patient's medical record so that it is readily accessible to hospital and other medical personnel in the event of the death of the patient.
157.06(6)
(6) Donees; purposes of anatomical gifts. 157.06(6)(a)(a) Any of the following persons may become donees of anatomical gifts for the purposes stated:
157.06(6)(a)1.
1. A hospital, physician or organ procurement organization, for transplantation, therapy, medical or dental education, research, or advancement of medical or dental science.
157.06(6)(a)2.
2. An accredited medical or dental school, college or university for education, research or advancement of medical or dental science.
157.06(6)(a)3.
3. A designated individual for transplantation or therapy needed by that individual.
157.06(6)(b)
(b) A donor may make an anatomical gift to a designated donee or without designating a donee. If a donee is not designated or if the donee is not available or rejects the anatomical gift, any hospital may accept the anatomical gift.
157.06(6)(c)
(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
sub. (3) (a), the donee may not accept the anatomical gift.
157.06(6m)
(6m) Consent for or limitation on certain uses of bones or tissue; requirements. 157.06(6m)(a)(a) A hospital, organ procurement organization, tissue bank, coroner, or medical examiner that provides a document of gift to a potential donor or to an individual under
sub. (3) (a) shall include in the document of gift the following sentences: "I understand that donated bones or tissues, including skin, may have numerous uses, including for reconstructive and cosmetic purposes, and that multiple organizations, including nonprofit and for-profit organizations, may recover, process, or distribute the donations. I further understand that I may, by this document, limit the use of the bones or tissues, including skin, that are donated or types of organizations that recover, process, or distribute the donation."
157.06(6m)(b)
(b) The document of gift under
par. (a) shall include, following the 2nd sentence required in
par. (a), all of the following:
157.06(6m)(b)1.
1. A line or space for the donor or individual under
sub. (3) (a) to sign or initial to acknowledge that he or she has read the sentences specified in
par. (a) or that the sentences have been read aloud to him or her. Except as provided in
sub. (3) (c) 2. c., failure of the donor or individual to place his or her initials or signature in the line or space is a refusal to make an anatomical gift of bones or tissues.
157.06(6m)(b)2.
2. A line or space for the donor or individual under
sub. (3) (a) to sign or initial and specify a limitation, if any, on the use of bones or tissues or on the types of organizations that recover, process, or distribute the donation.
157.06(6m)(c)
(c) If a potential donor or individual makes an anatomical gift under this subsection, the hospital, organ procurement organization, tissue bank, coroner, or medical examiner that provides to the donor or individual a document of gift under
par. (a) shall also provide the donor or individual with the telephone number and address of the agency or organization that recovers the anatomical gift.
157.06(6m)(d)
(d) The requester under
par. (a) shall provide the donor or the individual under
sub. (3) (a), as applicable, with a copy of any document of gift executed under the requirements of this subsection.
157.06(7)(a)(a) Delivery of a document of gift during the donor's lifetime to another is not required for the validity of an anatomical gift.
157.06(7)(b)
(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 after the donor's death. The document of gift, or a copy, may be deposited in any hospital, organ procurement organization or registry office that accepts it for safekeeping or for facilitation of procedures after death. On request of an interested person, upon or after the donor's death, the person in possession shall allow the interested person to examine or copy the document of gift.
157.06(8)(a)(a) Rights of a donee created by an anatomical gift are superior to rights of others except for autopsies under
sub. (10) (b). A donee may accept or reject an anatomical gift. If a donee accepts an anatomical gift of an entire body for a purpose other than transplantation or therapy, the body may not be delivered to the donee or the donee's agent if the surviving spouse or other person who assumes custody of the body requests a funeral service or other last rites for the deceased. If such a request is made, the body may not be delivered until after the funeral or rites have been conducted. If the entire body is given for transplantation or therapeutic purposes or 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 of the body, custody of the remainder of the body vests in the person under obligation to dispose of the body.
157.06(8)(b)
(b) The time of death shall be determined by a physician who attends the donor at death or, if none, the physician who certifies the death. Neither the physician who attends the donor at death nor the physician who determines the time of death may participate in the procedures for removing or transplanting a part of the donor's body unless the document of gift designates a particular physician under
sub. (2) (d).
157.06(8)(c)
(c) If there has been an anatomical gift, a physician may remove any donated parts of the body, a technician may remove any donated tissue or bone and an enucleator may remove any donated eyes or parts of eyes, after determination of death by a physician. Any individual acting under the direction of a physician and any funeral director licensed under
ch. 445 may perform the functions of an enucleator under this section if he or she has completed a course in eye enucleation and holds a valid certification of competence from a medical college approved by the medical examining board under
s. 448.05 (2). A certificate of competence shall be valid for 3 years.
157.06(9)(a)(a) Each hospital in this state, after consultation with other hospitals and with the organ procurement organization in whose designated service area the hospital is located, shall establish agreements or affiliations for coordination of procurement and use of human bodies and parts.
157.06(9)(b)
(b) A vascularized organ that is obtained by an organ procurement organization for which the designated service area primarily includes area in this state shall be used within that designated service area unless
par. (c) applies.
157.06(9)(c)
(c) If no suitable potential recipient for the vascularized organ is specified on a waiting list of a hospital that is within the designated service area of the organ procurement organization specified in
par. (b), that organ procurement organization shall offer the vascularized organ for use by any other organ procurement organization for which the designated service area primarily includes area in this state.
157.06(9)(d)
(d) If no suitable potential recipient for the vascularized organ is specified on a waiting list of a hospital that is within the designated service area of the organ procurement organization to which the vascularized organ is offered under
par. (c), the organ procurement organization specified in
par. (b) shall do one of the following:
157.06(9)(d)1.
1. If the organ procurement organization has found that it is in the best interests of persons on waiting lists in this state in need of transplanted vascularized organs and will increase the number of people receiving transplants to enter into a reciprocal sharing agreement with an organ procurement organization for which the designated service area primarily is outside this state, and has entered into such an agreement, offer the vascularized organ for use by the organ procurement organization under the agreement.
157.06(9)(d)2.
2. Offer the vascularized organ for use by an entity that distributes vascularized organs on a regional or national basis under a contract with the federal department of health and human services or a subcontract with a contractor with the federal department of health and human services.
157.06(9m)
(9m) Forms for removal of organs and certain tissues; rules. The department of health and family services shall promulgate rules prescribing all of the following:
