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Compliance

Cadaver Acquisition and Use

I. PURPOSE

The Revised Uniform Anatomical Gift Act is intended to regulate the donation of organs and cadavers within Hawaii, both for transplants and for anatomical research. These requirements are meant to prevent historically common abuses, such as theft and sale of bodies. Other regulations govern the safe and orderly use and disposition of dead bodies.

II. HISTORY

States began to pass anatomy acts in the mid-1800s in response to extreme methods of obtaining cadavers to sell to researchers. These anatomy acts allowed licensed persons to obtain donated bodies for dissection and provided penalties for unauthorized receipt of bodies. In 1968, the National Conference of Commissioners on Uniform State Laws (the Conference) approved the Uniform Anatomical Gift Act in order to address requirements for donating organs for transplants, therapy, or research. In 2006, the Conference updated the act in order to address the shortage of organs by outlining additional ways to make organ, eye, and tissue donations, and renamed it the Revised Uniform Anatomical Gift Act.

III. APPLICABILITY TO BYU–Hawaii

The Revised Uniform Anatomical Gift Act (Act) applies to anatomical gifts, meaning the donation of a deceased human body or body part for transplant, therapy, research, or education purposes. Because anatomical gifts may be made to universities for research or education purposes, educational institutions that plan to handle such gifts must be aware of and comply with the Act. Persons that remove, transport, or preserve deceased bodies must comply with regulation in Hawaii Revised Statues.

BYU–Hawaii must comply with the Act to the extent that it receives anatomical gifts. Because BYU–Hawaii handles cadavers, it must also comply with regulations regarding the removal, transportation, and preservation of dead bodies.

IV. REQUIREMENTS

General Requirements of the Revised Uniform Anatomical Gift Act

The Act grants universities access to anatomical gifts donated specifically to that university. This memo outlines the basic requirements for making an anatomical gift and for accepting an anatomical gift.

Requirements for Persons Making Anatomical Gifts

Under certain conditions, an adult (or, under certain conditions, a minor) may decide, before he or she dies, to donate his or her body upon death for purposes of transplant, therapy, research, or education. An agent of the donor, a parent of the donor, or the donor’s guardian may also consent, under certain conditions, to an individual’s becoming a donor. The donor or other authorized person may make an anatomical gift in accordance with state law (e.g., by authorizing a symbol indicating his or her gift to be printed on a driver license). Authorized persons may amend or revoke the gift, or refuse to make an anatomical gift, if they submit certain records or documents.

Family members or other specified individuals may make an anatomical gift of a decedent’s body in accordance with the Act. A person authorized to make an anatomical gift may do so through a signed “document of gift” (i.e., a donor card or other record used to make an anatomical gift), through an electronically recorded oral communication, or through a signed record written upon an oral communication.19

Requirements for Universities Accepting Anatomical Gifts

If there is more than one stated purpose of an anatomical gift in the document of gift, but there is no priority for the order of gifts, the gift is to be used for transplantation or therapy if suitable. Gifts that are unsuitable for transplantation or therapy may be used for research or education. Unless prohibited by another law, a university that receives an anatomical gift may conduct “any reasonable examination necessary to ensure the medical suitability of the body or part for its intended purpose.” Such an examination may include an examination of the donor’s medical records.

A university may not accept an anatomical gift if they know the gift was not made in accordance with state law or if they know that the decedent made a refusal regarding the gift. Before accepting the anatomical gift, a university must ensure that an emergency responder (e.g., a law enforcements officer) or a hospital has made a reasonable search of an individual who is believed to be dead or near death for documents of gift or other indication that the individual is or is not to be a donor.

A document of gift does not need to be delivered during the donor’s lifetime in order to be effective. A person who possesses a document of gift upon a donor’s death must allow the document of gift to be copied or examined by a person authorized to make or object to the making of an anatomical gift. A document of gift is valid only if executed in accordance with the Act and other relevant laws. If a document of gift is considered valid under such laws, Hawaii state law governs the interpretation of the document of gift.

State Regulations for Disposition of Deceased Persons

Per HRS section 338-28 Permit for removal, burial, or other disposition of body, when a death of fetal death occurs or a dead body is found, the body shall not be disposed of or removed from the registration district until a written permit has been issued by the local agent of the department of health, except that if the dead fetus is less than twenty-four weeks of gestation, no permits shall be required and except that if the death occurred as a result of an accident or other casualty occurrence, the local agent of the department of health may orally authorize the dead bodies to be removed from a registration district and airlifted or otherwise directly transported to the Honolulu registration district for the preparation and filing of death certificated and the issuance of written permits for further disposition.

The transportation of dead human bodies by a common carrier shall be conducted in such a manner as not to be a menace to the health of the general public. A burial-transit permit shall accompany the body. The body must be placed in a coffin or casket.

The University of Hawaii at Manoa’s John A. Burns School of Medicine’s Willed Body Program

The University of Hawaii receives bodies through provisions in the state code and through its Willed Body Program. The University of Hawaii has discretion over whether BYU–Hawaii has access to cadavers from the University of Hawaii Willed Body Program, and it has guidelines for how to treat cadavers while on loan that it expects BYU–Hawaii to follow. The University of Hawaii also requires BYU–Hawaii to return its cadavers, including parts that have been dissected, when term of the transfer is over so that the University of Hawaii can properly dispose of the cadavers.

V. PENALTIES

Persons who shall give, offer, or promise any money or other things of value to any other person in consideration of receiving a dead human body may be imprisoned up to one year, fined up to $5,000, or both. Any person that seeks to display a dead human body for commercial purposes may be subject to penalties mentioned above.