§ 22-19-50. Short title
This article may be cited as the "Alabama Uniform Anatomical Gift Act."
§ 22-19-51. Definitions
As used in this article, the following terms have the following meanings:
(1) ANATOMICAL GIFT. A donation of all or part of a human body to take effect upon or after death.
(2) DECEDENT. A deceased individual and includes a stillborn infant or fetus.
(3) DOCUMENT OF GIFT. A card, a statement attached to or imprinted on a motor vehicle operator's or chauffeur's license, a will, or other writing used to make an anatomical gift.
(4) DONOR. An individual who makes an anatomical gift of all or part of the individual's body.
(5) ENUCLEATOR. An individual who is licensed pursuant to Article 4, commencing with Section 34-13-150, of Chapter 13 of Title 34 or is certified pursuant to Article 6, commencing with Section 22-19-100.
(6) HOSPITAL. A facility licensed, accredited or approved
as a hospital under the provisions of Article 2, commencing with Section
22-21-20, of Chapter 21 or a facility operated as a hospital by the United
States
government.
(7) LOCAL PUBLIC HEALTH OFFICIAL. A physician acting in the capacity of an area health officer, local health officer, or county health officer.
(8) PART. An organ, tissue, eye, bone, artery, blood, fluid, or other portion of a human body.
(9) PERSON. An individual, corporation, business trust, estate, trust, partnership, joint venture, association, government, governmental subdivision or agency, or any other legal or commercial entity.
(10) PHYSICIAN or SURGEON. An individual licensed by the Medical Licensure Commission of Alabama and authorized to practice medicine and surgery or osteopathy and surgery.
(11) PROCUREMENT ORGANIZATION. A person licensed, accredited, or approved under the laws of any state for procurement, distribution, or storage of human bodies or parts.
(12) STATE. A state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico.
(13) SURGEON'S ASSISTANT. An individual who is licensed and certified as a surgeon's assistant by the State Board of Medical Examiners to remove or process a part.
§ 22-19-52. 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 subsection (a) of Section 22-19-56, (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. If the donor cannot sign, the document of gift
shall be signed by another individual and by two 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, the document of gift shall comply with subsection (b). 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 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, surgeon's assistant, 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 gift is
unaffected.
(f) A donor may amend or revoke an anatomical gift, not made by will, only by any of the following methods:
(1) A signed statement.
(2) An oral statement made in the presence of two individuals.
(3) Any form of communication during a terminal illness or injury addressed to a physician or surgeon.
(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 wills, 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.
(i) An individual may refuse to make an anatomical gift of
the individual's body or part by (1) a writing signed in the same manner
as a document of gift, (2) a statement attached to or imprinted on 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 22-19-53 or on a removal
or release
of other parts under Section 22-19-54.
(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).
§ 22-19-53. Making, revoking, and objecting to anatomical gifts by others.
(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.
(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) in any of the following instances:
(1) If a person in a prior class is available at the time of death to make an anatomical gift.
(2) If the person proposing to make an anatomical gift knows of a refusal or contrary indications by the decedent.
(3) If the person proposing to make an anatomical gift knows of an objection to making an anatomical gift by a member of the person's class or a prior class.
(c) An anatomical gift by a person authorized under subsection (a) shall be made by (1) a document of gift 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 if, before procedures have begun for the removal of a part from the body of the decedent, the physician, surgeon, surgeon's assistant, or enucleator removing the part knows of the revocation.
(e) A failure to make an anatomical gift under subsection (a) is not an objection to the making of an anatomical gift.
§ 22-19-54. Authorization by coroner; medical examiner; local public health official.
(a) The coroner or medical examiner may release and permit the removal of a part from a body within that official's custody, for transplantation or therapy, if each of the following requirements are met:
(1) The official has received a request for the part from a hospital, physician, surgeon, or procurement organization.
(2) The official has made a reasonable effort, taking into account the useful life of the part, to locate and examine the decedent's medical records and inform persons listed in subsection (a) of Section 22-19-53 of their option to make, or object to making, an anatomical gift.
(3) The official does not know of a refusal or contrary indication by the decedent or objection by a person having priority to act as listed in subsection (a) of Section 22-19-53.
(4) The removal will be by a physician, surgeon, surgeon's assistant, or certified procurement transplant coordinator certified by the American Board of Transplant Coordinators; but in the case of eyes, by one of them or by an enucleator.
(5) The removal will not interfere with any autopsy or investigation.
(6) The removal will be in accordance with accepted medical standards.
(7) Cosmetic restoration will be done, if appropriate.
(b) If the body is not within the custody of the coroner or medical examiner, the local public health officer may release and permit the removal of any part from a body in the local public health officer's custody for transplantation or therapy if the requirements of subsection (a) are met.
(c) An official releasing and permitting the removal of a part shall maintain a permanent record of the name 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.
§ 22-19-55. Routine inquiry and required request; search and notification.
(a) On or before admission to a hospital, or as soon as possible
thereafter, a person designated by the hospital shall ask each patient
who is at least 18 years of age: "Are you an organ or tissue donor?" If
the answer is affirmative the person shall request a copy of the
document of gift. If the answer is negative or there is no answer and the
attending physician consents, the person designated shall discuss with
the patient the option to make or refuse to make an anatomical
gift.
(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 subsection (a) of Section 22-19-53. The request shall 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 which may include consultation with the designated organ procurement
organization, for a purpose specified in Section 22-19-56.
(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 whom the searcher believes is dead or near death.
(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 subdivision (1) of subsection (c), and the individual or body to whom it relates is taken to a hospital, the hospital shall be notified of the contents and the document or other evidence shall 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 subsection (a) of Section 22-19-53 or a release and removal of a part has been permitted pursuant to Section 22-19-54, 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 not, it shall notify an appropriate procurement organization. The hospital shall cooperate in the implementation of the anatomical gift or release and removal of a part.
§ 22-19-56. Persons who may become donees; purposes for which anatomical gifts may be made
(a) All of the following persons may become donees of anatomical gifts for the purposes stated:
(1) A hospital, physician, surgeon, or 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.
(3) A designated individual for transplantation or therapy needed by that individual.
(b) An anatomical gift may be made 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, 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 subsection (a) of Section 22-19-53, the
donee may not accept the an(Act 2003-347, § 1.)
§ 22-19-57. 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 after death. The document of gift, or a copy, may be deposited in any hospital, 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.
§ 22-19-58. 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 subsection (b)
of Section 22-19-59.2. 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 shall 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 subsection (d) of Section 22-19-52.
(c) If there has been an anatomical gift, a surgeon's assistant 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.
§ 22-19-59. Coordination of procurement and use
Each hospital in this state, after consultation with other hospitals and procurement organizations, shall establish agreements or affiliations for coordination of procurement and use of human bodies and parts.
§ 22-19-59.1. 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) The violation of this section is a Class C felony.
§ 22-19-59.2. 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 article are subject to the laws of this state governing autopsies.
(c) In the absence of wantonness, or willful misconduct, a hospital, physician, surgeon, coroner, medical examiner, local public health officer, enucleator, surgeon's assistant, or other person, who acts in accordance with this article or with the applicable anatomical gift law of another state or a foreign country or attempts in good faith to do so is not liable for that act in a civil action or criminal proceeding.
(d) In the absence of wantonness, or willful misconduct, an individual who makes an anatomical gift pursuant to Section 22-19-52 or Section 22-19-53 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.
§ 22-19-59.3. Administrative rules
The State Board of Health shall adopt rules under the Administrative Procedure Act to implement this article.
§ 22-19-59.4. Legislative recognition
The Alabama Legislature will annually honor the memory of individuals who have made a "gift of life" to another individual during the previous year by their generous donation pursuant to the Alabama Uniform Anatomical Gift Act.
§ 22-19-59.5. Transitional provisions
This article 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 January
1, 2004.
§ 22-19-59.6. Uniformity of application and construction
This article shall be applied and construed to effectuate its general purpose to make uniform the law with respect to the subject of this article among states enacting it.
§ 22-19-59.7. Severability
If any provision of this article or its application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this article which can be given effect without the invalid provision or application, and to this end the provisions of this article are severable.
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