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Legal Next of Kin Consent for Donation (2.06)

Legal Next of Kin Consent for Donation (2.06) - Policies, Clinical, UWHC Clinical, Department Specific, UW Organ and Tissue Donation

2.06



POLICY
Established Date: January 2001
Effective Date: January 2018
Title: Legal Next of Kin Consent for Donation Policy Number: 2.06

Electronically Approved By: Michael E. Anderson, PA-C Anthony M. D’Alessandro, M.D.
Executive Director Medical Director


Page 1 of 2
PURPOSE

The purpose of this policy is to ensure the opportunity of organ, tissue, and eye donation is offered to all
families of patients being evaluated for organ donation potential when medically appropriate by University
of Wisconsin Organ and Tissue Donation (UW OTD). UW OTD will obtain consent for the donation of
organs, tissue, and eye in accordance with all federal and state laws, all other applicable regulatory
requirements.

FORMS

State of Wisconsin Document of Anatomical Gift Authorization for Organ and Tissue Donation Form
State of Michigan and State of Illinois Hospital Specific Consent Forms
Hospital specific procedural consent forms for medications and procedures related donation after
circulatory death (DCD)

POLICY
A. For patients that have potential for organ and tissue and/or eye donation, UW OTD will also
obtain consent for tissue and eye donation on behalf of the tissue and eye banks.
B. All families of patients will be offered the opportunity of donation if it is medically appropriate
for the patient.
C. UW OTD staff will determine if the patient designated first person authorization per UW OTD
policy 2.15.
D. If no first person authorization is present, the legal next-of-kin (LNOK) of the patient will be
offered the opportunity to provide consent for donation. The LNOK will be identified per state
law.
E. UW OTD and hospital staff will collaborate to identify the most appropriate next steps to offer
the LNOK an opportunity to provide consent for donation.
F. The LNOK will be offered the opportunity by an individual that completed designated requestor
training per UW OTD policy 1.11 and in collaboration with UW OTD and other hospital staff as
appropriate.
G. If consent for donation is obtained in person, the designated requestor will complete the
appropriate consent form(s) with the LNOK. If consent for donation was obtained verbally and
the LNOK is not present to sign the consent form(s), the conversation will be recorded or will be
witnessed by two UW OTD and/or hospital staff members.



POLICY
Established Date: January 2001
Effective Date: January 2018
Title: Legal Next of Kin Consent for Donation Policy Number: 2.06

Electronically Approved By: Michael E. Anderson, PA-C Anthony M. D’Alessandro, M.D.
Executive Director Medical Director


Page 2 of 2
1. If UW OTD and/or hospital staff members use a recorded line, it can be provided by
Statline, the UW OTD referral service.
i. Staff will contact Statline to make arrangements for the recorded line. Statline
will facilitate the recording.
ii. Staff will conduct the consent conversation and complete the appropriate
consent form(s) with the reference number for the recorded line, provided by
Statline.
2. If a recorded line is not used, two UW OTD and/or hospital staff members will witness
the verbal conversation with the LNOK and will complete the appropriate consent
form(s).
H. Copies of the completed consent form(s) will be:
1. Provided to the LNOK in person or through the mail.
2. Retained by UW OTD in the patient record.
3. Retained by the hospital in the patient’s medical record
4. Provided to the applicable tissue and/or eye bank agencies and applicable transplant
centers when appropriate.
I. Hospital or UW OTD staff will provide the family with information about how to contact UW
OTD with any questions.
J. If consent for donation is declined, the designated requestor and UW OTD staff will collaborate
to discuss the reasons why the LNOK declined and determine the appropriate next steps.
1. If the LNOK will not be offered another opportunity to provide consent, the LNOK
decision details will be documented in the UW OTD patient record and will be
communicated to the appropriate referral service and recovery agencies.
2. If the LNOK will be offered another opportunity to provide consent, the procedures in
this policy will be followed.

REFERENCES
Wisconsin Statute § 157.06
Wisconsin Uniform Anatomical Gift Act (157.06)
Michigan Revised Uniform Anatomical Gift Law (Act 368, Article 10)
755 Illinois Compiled Statute § 50
UW OTD Policy 1.11 and 2.15