Pennsylvania § 8658 - Gifts of vascularized composite allografts.

§ 8658. Gifts of vascularized composite allografts.

(a) Gift.--The following apply to vascularized composite allografts:

(1) If the individual whose death is imminent or has died in the hospital has a document of gift which authorizes a gift of a vascularized composite allograft, the organ procurement organization representative or the designated requestor shall attempt to notify a surrogate decision maker.

(2) If no document of gift is known to the organ procurement organization representative or the designated requestor, then the organ procurement organization representative or the designated requestor may ask the surrogate decision maker whether the individual had a validly executed document of gift. If there is no evidence of gift of a vascularized composite allograft by the individual, the organ procurement organization representative or the designated requestor shall notify the surrogate decision maker of the option to donate a vascularized composite allograft. The notification shall be performed in accordance with section 8656 (relating to procedure for requesting hands, facial tissue, limbs and other vascularized composite allografts).

(3) The hospital administrator or the hospital administrator's designated representative shall indicate in the medical record of the individual the information under this paragraph and paragraph (2). The information shall also be communicated by the hospital administrator or the hospital administrator's designee to the organ procurement organization or designated requestor, as appropriate:

(i) whether or not a document of gift is known to exist and whether a gift of a vascularized composite allograft was made;

(ii) if a gift of a vascularized composite allograft was made, the name of the person granting the gift and that person's relationship to the individual; and

(iii) all of the following:

(A) Whether the individual executed an advance health care directive, living will, power of attorney, health care power of attorney, will or other document, including a do-not-resuscitate order, evidencing an intention to limit, withdraw or withhold life-sustaining measures.

(B) Whether the individual indicated in an advance health care directive, living will, power of attorney, health care power of attorney, will or other document an intention to limit the anatomical gifts of the individual in any way, including the intention to limit an anatomical gift to parts of the body which do not require a ventilator or other life-sustaining measures, or to deny making or refusing to make a gift of a vascularized composite allograft.

(C) Whether the individual amended or revoked a gift of a vascularized composite allograft, in any document specified in this subparagraph or in any other document or in accordance with section 8615 (relating to amendment or revocation of gift).

(b) Testing.--

(1) This subsection shall apply if:

(i) a hospital refers an individual whose death is imminent or who has died in a hospital to an organ procurement organization;

(ii) the organ procurement organization, in consultation with the individual's attending physician, determines, based upon a medical record review and other information supplied by the individual's attending physician, that the individual may be a prospective donor of a vascularized composite allograft; and

(iii) the individual has not:

(A) indicated in an advance health care directive, a living will, power of attorney, health care power of attorney, will, do-not-resuscitate order or other document an intention to either limit the anatomical gifts of the individual to parts of the body which do not require a ventilator or other life-sustaining measures or indicated an intention to deny making or refusing to make a gift of a vascularized composite allograft; or

(B) amended or revoked a gift of a vascularized composite allograft in any document specified in subsection (a)(3) or in any other document or in accordance with section 8615.

(2) If the requirements of paragraph (1) are met, the following shall apply:

(i) Subject to the wishes expressed by the individual under subsection (a)(3), the organ procurement organization may conduct a blood or tissue test or minimally invasive examination which is reasonably necessary to evaluate the medical suitability of a vascularized composite allograft that is or may be the subject of a gift. Testing and examination under this subparagraph shall comply with a denial or refusal to make a gift of a vascularized composite allograft or any limitation expressed by the individual with respect to the vascularized composite allograft, or a limitation in the provision of a ventilator or other life-sustaining measures, as specified in subsection (a)(3) or a revocation or amendment to a gift of a vascularized composite allograft as specified in a document in subsection (a)(3) or in any other document or in accordance with section 8615. The results of tests and examinations under this subparagraph shall be used or disclosed only:

(A) to evaluate medical suitability for donation of a vascularized composite allograft and to facilitate the donation process; and

(B) as required or permitted by law.

(ii) Subject to the wishes expressed by the individual under subsection (a)(3), the hospital may not withdraw any measures which are necessary to maintain the medical suitability of the vascularized composite allograft until the organ procurement organization or designated requestor, as appropriate, has had the opportunity to advise the surrogate decision maker of the option to make a gift of a vascularized composite allograft and has received or been denied authorization to proceed with recovery of the vascularized composite allograft.

(c) Testing after death.--Subject to the individual's wishes under subsection (a)(3), after an individual's death, a person to whom an anatomical gift may pass under section 8662 (relating to donees and vascularized composite allografts) may conduct a test or examination which is reasonably necessary to evaluate the medical suitability of the vascularized composite allograft for its intended purpose.

(d) Recipients.--Subject to the individual's wishes under subsection (a)(3) and as set forth in this subchapter, a person that accepts a gift of a vascularized composite allograft may allow embalming, burial or cremation and the use of remains in a funeral service. The person to whom the part passes under section 8662, upon the death of the individual and before embalming, burial or cremation, shall cause the vascularized composite allograft to be removed without unnecessary mutilation.

(e) Physicians.--Neither the physician who attends the individual at death nor the physician who determines the time of the individual's death may participate in the procedures for removing or transplanting a vascularized composite allograft.

(f) Coordination of procurement and use.--The organ procurement organization, hospital personnel and other individuals involved in the process of recovering a vascularized composite allograft shall limit the testing and examination of the individual under this section so as to comply with the wishes of the individual under subsection (a)(3).