Transplantation and Anatomy Act - Organ donation

Discuss the rules of information disclosure surrounding transplantation and organ donation

1. Do not disclose or give to any other person any information or document whereby the identity of the person or a deceased person: a) from whose body tissue has been removed for the purpose of transplantation, therapeutic or other scientific purposes b) with respect to whom or with respect to whose body a consent or an authority has been given under this Act c) into whose body tissue has been, is being, or may be, transplanted; may become publicly known. UNLESS: 1. in pursuance of an order of a Court or when otherwise required by the law 2. for purposes of hospital administration or bona fide medical research 3. with consent of the person to whom the information relates.

Discuss the law in relation to consent for removal of tissue where body of the deceased is in a hospital

1. body of deceased is in hospital 2. the deceased person had not, during their lifetime, expressed an objection to the removal after death of tissue from their body 3. the senior available NOK of the deceased person has consented to the removal of tissue from the body of the deceased person for transplant or for therapeutic purposes or other medical/scientific purposes. 4. under the consent, a designated officer may, by signed writing, authorise the removal of tissue from the body of the deceased person 5. senior available NOK may make it known to a designated officer at any time BEFORE the death of a person that they have no objection to the removal (after death) of tissue from the body of the person - should be in written form but can also be given orally (record asap) 6. if deceased person (during their lifetime) signed a written consent to removal of tissue after death - then this is in accordance with their consent.

Discuss the law surrounding donation of tissues by a living child

1. children can only donate regenerative tissue 2. Only if the regenerative tissue is being donated to a sibling or parent 3. Tissue can be removed regardless of whether the child understands the procedure 4. There must be an accompanying certificate of consent: a) if child is Gillick competent - they can sign b) if child isn't Gillick competent - parent can sign 5. certificate states - the recipient family member would die without the transplantation 6. certificate states - the procedure is of minimal risk to the child 7. If the medical practitioner has been informed that a parent of the child or the child is not, or is no longer, in agreement with removal and transplantation of the tissue, then they cannot undergo the procedure even with the certificate already signed. 8. Tissue removal must not be performed by the doctor or designated officer who gave the certificate 9. Without 'sufficient authority' given in the form of a signed certificate, the operation would be unlawful and subject the doctor to tortious or criminal liability

Discuss the law surrounding donation of tissue by a living, competent adult

1. living adult of sound mind, in light of medical advice given by a medical practitioner may consent to the removal of regenerative and/or non-regenerative tissue. 2. consent must be signed in the presence of a designated officer and specify the tissues to be removed and the purpose of the removal. 3. designated officer must provide a certificate in relation to the consent; stating the following: a) terms of consent b) that the requisite medical advice was given c) that the consent was given in the presence of the certifier d) that the donor adult is of sound mind e) that the donor's consent was freely given 4. removal of non-regenerative tissue may only take place after 24 hours has elapsed since the signing of consent and can only be used for transplantation into the body of another living person.

Discuss the law surrounding donation of tissues by an incompetent adult

1. matters are dealt under the Guardianship and Administration Act 2. if adult has made an AHD regarding tissue donation - that must be followed 3. Tissue donation cannot be consent to by an enduring power of attorney or SHA 4. Decision will generally be made by the Queensland Civil and Administrative Tribunal (QCAT) 5. QCAT may consent to removal of tissue from an incompetent adult for donation to another person if the tribunal is satisfied: a) risk to adult is small b) risk of failure of donated tissue is low c) life of the proposed recipient would be in danger without donation d) no other compatible donor is reasonably available e) there is, or has been, a close personal relationship between the adult and the proposed recipient 6. If the adult objects to the removal of tissue for donation, QCAT cannot consent to it.

What usually happens when the deceased's views are known to allow removal of tissue after death BUT the senior NOK is not consenting to it?

1. none of the Australian provisions say that a senior NOK can override the express consent of the deceased to donate - i.e. no legal obligation to follow orders of the NOK 2. However, it's general belief amongst healthcare professionals that such rights do exist

Discuss why it is important to separate retrieval and donation teams

1. prevents conflict of interest 2. prevent reluctance of saving a patient who may be a suitable donor 3. prevent knowledge of the recipient influencing medical behaviour 4. reduce the transparency in the allocation of organs

Lit the different types of transplants possible

1. regenerative tissue = tissue which will grow back 2. non-regenerative tissue = tissue wont grow back once removed

Under the TAA, when does a death occur?

A person has died when there has occurred: 1. Irreversible cessation of circulation of blood in the body of the person (cardiorespiratory standard); or 2. irreversible cessation of all functioning of the brain of the person (brain-death test)