[37] Bill 82 Original (PDF)
Bill 82
Bill 822000
An Act to amend
the Human Tissue Gift Act
to establish a routine referral system
to co-ordinate activities relating
to tissue donation on death
Her Majesty, by and with the advice and consent of the Legislative Assembly of the Province of Ontario, enacts as follows:
1.The Human Tissue Gift Act is amended by adding the following Part:
PART IV
ROUTINE REFERRAL
Definitions
14. In this Part, "
Agency" means the Ontario Tissue Donation Agency; ("Agence") "
facility" means a hospital approved under the Public Hospitals Act or a long-term care facility as defined in subsection 59 (1) of the Long-Term Care Act, 1994\; ("tablissement") "
prescribed" means prescribed by the regulations made under this Part; ("prescrit") "
substitute", when used in relation to a patient, means the person described in clause 5 (2) (a), (b), (c), (d), (e) or (f), as the case may be. ("substitut")
Ontario Tissue Donation Agency
15. (1)A corporation without share capital known in English as Ontario Tissue Donation Agency and in French as Agence ontarienne des dons de tissus is hereby established.
Objects
(2)The objects of the Agency are:
1.The establishment and operation of a province-wide register of consents.
2.The performance of the functions given to the Agency by this Part.
Prescribed facility, notice to Agency
16. (1)A prescribed facility shall notify the Agency immediately in the event of the death or impending death of a patient who is in the facility's care.
Details
(2)The notice shall be given by telephone or by electronic means and shall include the following information:
1.The patient's name, date of birth and health number.
2.The cause or expected cause of death.
3.Any past and current medical history that is available and is relevant to the donation of tissue.
Medical suitability
(3)On receiving the notice, the Agency shall immediately,
(a)determine whether any of the patient's tissues are likely to be suitable for donation and if so, determine whether there is a need for them; and
(b)advise the facility of the outcome.
Exception, certain causes of death
17. If a patient's cause or expected cause of death is a disease listed in the regulations, no notice need be given under section 16.
Investigation re consent
18. (1)If the Agency advises the facility that any of the patient's tissues are likely to be suitable for donation and that there is a need for them, the facility shall immediately investigate whether a consent exists that is in respect of the patient and relates to donation of those tissues.
Notice if consent exists
(2)If the facility finds that such a consent exists, it shall immediately,
(a)notify the Agency and the patient's substitute of the fact; and
(b)ensure that a copy of the relevant document is placed in the patient's medical record.
Notice if no consent exists
(3)If the facility finds that no consent described in subsection (1) exists, it shall immediately advise the Agency of the fact.
Refusal to consent
(4)If the facility's investigation indicates a refusal to give a consent described in subsection (1) or to give any consent, it shall not take further action to obtain a consent.
Notice to substitute if consent exists
19. (1)When the facility notifies the patient's substitute under subsection 18 (2), it shall also tell the substitute whether it intends to act on the consent.
Same, if no consent exists
(2)If no consent described in subsection 18 (1) is found in the investigation under that subsection, a person designated to act on behalf of the facility shall, in accordance with the guidelines established under section 21,
(a)approach the patient's substitute and advise that no such consent exists,
(b)give the substitute any evidence the facility has of the patient's intention in relation to giving or refusing such a consent or any consent; and
(c)determine whether the substitute will give such a consent.
Patient's attending physician
(3)The facility shall ensure that the patient's attending physician is promptly advised of any action taken under subsection (2).
Decision to refuse consent
(4)If the substitute refuses to give the consent described in subsection 18 (1) or to give any consent in respect of the patient, the facility shall take no further action to obtain a consent in respect of the patient.
Patient's death
(5)The facility shall ensure that the person who acts on its behalf under subsection (2) is not the person who first advises the substitute of the patient's death or impending death.
Designated persons
20. (1)Any of the following persons may be designated by a facility to act on its behalf under subsection 19 (2):
1.A physician.
2.A registered nurse.
3.A social worker or pastoral care worker who works at the facility.
4.Any employee of the facility or of the agency who has appropriate training and experience.
Special training
(2)A person who is designated under subsection (1) shall, before acting on the facility's behalf under subsection 19 (2), receive special training in accordance with paragraph 3 of section 21.
Guidelines
21. A prescribed facility shall develop and implement, in consultation with the Agency, guidelines for the following purposes:
1.To ensure timely action under this Part, including section 16.
2.To determine who will first advise a patient's substitute of the patient's death or impending death.
3.To specify the special training required for persons who are designated under subsection 20 (1).
4.To ensure that a complete and confidential record is kept of actions taken by or on behalf of the facility under this Part.
5.To ensure that actions taken by or on behalf of the facility under this Part are as sensitive and appropriate as possible.
Regulations
22. The Lieutenant Governor in Council may make regulations,
(a)prescribing facilities for the purposes of this Part;
(b)listing diseases for the purposes of section 17.
2.Section 11 of the Health Insurance Act, as amended by the Statutes of Ontario, 1994, chapter 17, section 70, is further amended by adding the following subsection:
Consent or refusal, Human Tissue Gift Act
(2.1)Before a health card is issued to a person who is 16 years of age or older, he or she shall be given an opportunity to give or refuse consent for the purposes of Part II of the Human Tissue Gift Act.
Commencement
3.This Act comes into force on a day to be named by proclamation of the Lieutenant Governor.
Short title
4.The short title of this Act is the Human Tissue Gift Amendment Act, 2000.
EXPLANATORY NOTE
The Bill amends the Human Tissue Gift Act by adding a new Part IV to establish a "routine referral" system to co-ordinate activities relating to tissue donation on death. (The Act defines "tissue" as including organs.) A new Ontario Tissue Donation Agency will operate a province-wide register of consents and work with health facilities to ensure that opportunities for donation are not missed.
The Bill is designed for gradual implementation by means of regulations bringing individual health facilities under the application of Part IV.
The steps to be taken by such health facilities when potential donors in their care die or are near death are set out in detail. Specially trained persons will approach the patients' families to discuss the possibility of giving consent. Patients' physicians will also be notified. If consent is refused, no further action may be taken.
The Bill also amends the Health Insurance Act to require that a person 16 years of age or older to whom a health card is issued must first have an opportunity to give or refuse consent to tissue donation on death.