In this subtitle the following words have the meanings indicated. “Agent” means an individual: Authorized to make health care decisions on behalf of a principal by a power of attorney for health care; or Expressly authorized to make an anatomical gift on behalf of a principal by a record signed by the principal. “Anatomical gift” means a donation of all or part of a human body to take effect after the donor’s death for the purpose of transplantation, therapy, research, or education. “Decedent” means a deceased individual whose body or part is or may be the source of an anatomical gift. “Decedent” includes: A stillborn infant; and Subject to restrictions imposed by law other than this subtitle, a fetus. “Decedent” does not include a blastocyst, embryo, or fetus that is the subject of an induced abortion. “Disinterested witness” means a witness other than: A spouse, child, parent, sibling, grandchild, grandparent, or guardian of an individual who makes, amends, revokes, or refuses to make an anatomical gift; or Another adult who exhibits special care and concern for an individual who makes, amends, revokes, or refuses to make an anatomical gift. “Disinterested witness” does not include a person to which an anatomical gift may pass under § 4–509 of this subtitle. “Document of gift” means a donor card or any other record used to make an anatomical gift. “Document of gift” includes a statement or symbol on a driver’s license, an identification card, or a donor registry. “Donor” means an individual whose body or part is the subject of an anatomical gift. “Donor registry” means a database that contains records of anatomical gifts and amendments to or revocations of anatomical gifts as provided in § 4–516 of this subtitle. “Driver’s license” means a license or permit issued by the Motor Vehicle Administration to operate a vehicle, whether or not conditions are attached to the license or permit. “Driver’s license” includes a learner’s permit. “Emancipated minor” means a person under the age of 18 years who is: Married; A parent; Serving in the military; Emancipated by court order; Living separately from the parents of the person and is self–supporting; or Emancipated for another purpose recognized by law. “Eye bank” means a person that: Is licensed, accredited, or regulated under federal or state law to engage in the recovery, screening, testing, processing, storage, or distribution of human eyes or portions of human eyes; Is accredited by the Eye Bank Association of America or the American Association of Tissue Banks; and Has a permit issued in accordance with Title 17, Subtitle 3 of the Health – General Article. “Guardian” means a person appointed by a court to make decisions regarding the support, care, education, health, or welfare of an individual. “Guardian” does not include a guardian ad litem, unless the guardian ad litem is authorized by a court to consent to donation. “Hospital” means a facility licensed as a hospital under the law of any state or a facility operated as a hospital by the United States, a state, or a subdivision of a state. “Identification card” means an identification card issued by the Motor Vehicle Administration. “Know” means to have actual knowledge. “Nontransplant tissue bank” means a person that recovers, screens, procures, transports, stores, or arranges for the storage and distribution of a body or part solely for the purpose of research, training, or education. “Nontransplant tissue bank” includes: The State Anatomy Board; A program for a purpose described in paragraph (1) of this subsection operated by officers or employees of the United States; or A nonprofit organization described in paragraph (1) of this subsection permitted to operate under § 5–409 of the Health – General Article. “Nontransplant tissue bank” does not include: An eye bank; An organ procurement organization; or A transplant tissue bank. “OCME” means the Office of the Chief Medical Examiner. “Organ procurement organization” means a person designated by the Secretary of the United States Department of Health and Human Services as an organ procurement organization. “Parent” means a parent whose parental rights have not been terminated. “Part” means an organ, an eye, or tissue of a human being. “Part” does not include the whole body. “Physician” means an individual authorized to practice medicine or osteopathy under the law of any state. “Procurement organization” means an eye bank, an organ procurement organization, or a tissue bank. “Prospective donor” means an individual who is dead or whose death is imminent and has been determined by a procurement organization to have a part that could be medically suitable for transplantation, therapy, research, or education. “Prospective donor” does not include an individual who has made a refusal. “Reasonably available” means able to be contacted by a procurement organization without undue effort and willing and able to act in a timely manner consistent with existing medical criteria necessary for the making of an anatomical gift. “Recipient” means an individual into whose body a decedent’s part has been or is intended to be transplanted. “Record” means information that is inscribed on a tangible medium or is stored in an electronic or any other medium and is retrievable in perceivable form. “Refusal” means a record created under § 4–505 of this subtitle that expressly states an intent to bar other persons from making an anatomical gift of an individual’s body or part. “Sign” means to: Have present intent to authenticate or adopt a record; and Execute or adopt a tangible symbol; or Attach to or logically associate with the record an electronic symbol, sound, or process. “Technician” means an individual determined to be qualified to remove or process parts by an appropriate organization that is licensed, accredited, or regulated under federal or state law. “Technician” includes an enucleator. “Tissue” means a portion of the human body other than an organ or eye. “Tissue” does not include: Blood unless the blood is donated for the purpose of research or education; or An ovum or sperm for the purpose of creating an embryo to use in therapy, research, or education, unless the anatomical gift is made by the donor to the spouse of the donor. “Tissue bank” means a transplant tissue bank or nontransplant tissue bank. “Transplant hospital” means a hospital that furnishes organ transplants and other medical and surgical specialty services required for the care of transplant patients. “Transplant tissue bank” means a person that is licensed, accredited, or regulated under federal or State law to engage in the recovery, screening, testing, processing, storage, or distribution of tissue in accordance with Title 17, Subtitle 3 of the Health – General Article.

This subtitle applies to an anatomical gift or an amendment to, a revocation of, or a refusal to make an anatomical gift whenever made.

Subject to § 4–506 of this subtitle, an anatomical gift may be made during the life of a donor for the purpose of transplantation, therapy, research, or education by: A donor who is an adult; or A donor who is a minor, if the minor is: Emancipated; or Authorized under State law to apply for a driver’s license because the donor is at least 15 years and 9 months old; An agent of a donor, unless a power of attorney for health care or other record prohibits the agent from making an anatomical gift; A parent of a donor, if the donor is an unemancipated minor; or A guardian of a donor. A donor may make an anatomical gift: By authorizing a statement or symbol indicating that the donor has made an anatomical gift to be imprinted on the donor’s driver’s license or identification card; By will; During a terminal illness or an injury of the donor, by any form of communication addressed to at least two adults, at least one of whom is a disinterested witness; or As provided in subsection (c) of this section. A donor or other person authorized to make an anatomical gift under this section may make a gift by: A donor card or other record signed by the donor or other person making the gift; or Authorizing that a statement or symbol indicating that the donor has made an anatomical gift be included on a donor registry. If a donor or other person authorized to make an anatomical gift under this section is physically unable to sign a record, the record may be signed by another individual at the direction of the donor or other person and shall: Be witnessed by at least two adults, at least one of whom is a disinterested witness, who have signed at the request of the donor or other person; and State that the record has been signed and witnessed as provided in item (i) of this paragraph. Revocation, suspension, expiration, or cancellation of a driver’s license or an identification card that indicates an anatomical gift does not invalidate the gift. An anatomical gift made by will takes effect on the donor’s death whether or not the will is probated. If a will that makes an anatomical gift is invalidated after the donor’s death, the anatomical gift does not become invalid. On or after July 1, 2022, a person who elects to be a donor may designate any of the following purposes for the anatomical gift: Research and education; and Transplantation and therapy. By July 1, 2022, the organ procurement organization or its designated affiliate shall produce and provide to each Motor Vehicle Administration location educational materials that include definitions of: Anatomical gift; Research and education; and Transplantation and therapy. Each Motor Vehicle Administration location shall prominently display the educational materials and make available the educational materials to prospective donors on request. The Motor Vehicle Administration shall adopt regulations by July 1, 2022, to carry out subsections (f) and (g) of this section.

Subject to § 4–506 of this subtitle, a donor or any other person authorized to make an anatomical gift under § 4–503 of this subtitle may amend or revoke an anatomical gift by: A record signed by: The donor; The other person; or Subject to subsection (b) of this section, if the donor or other person is physically unable to sign, another individual acting at the direction of the donor or the other person; or A later–executed document of gift that expressly or by inconsistency amends or revokes the previous anatomical gift or portion of the anatomical gift. A record signed in accordance with subsection (a)(1)(iii) of this section shall: Be witnessed by at least two adults, at least one of whom is a disinterested witness, who have signed at the request of the donor or the other person; and State that the record has been signed and witnessed as provided in item (1) of this subsection. Subject to § 4–506 of this subtitle, a donor or any other person authorized to make an anatomical gift under § 4–503 of this subtitle may revoke the anatomical gift by the destruction or cancellation of the document of gift, or the portion of the document of gift used to make the gift, with the intent to revoke the gift. During a terminal illness of a donor, or while a donor is injured, the donor may amend or revoke an anatomical gift that was not made by will by any form of communication addressed to at least two adults, at least one of whom is a disinterested witness. A donor who makes an anatomical gift by will may amend or revoke the gift in the manner provided for amendment or revocation of wills or as provided in subsection (a) of this section. An anatomical gift made by a donor designation on a driver’s license or an identification card may be revoked by giving written notice to the Motor Vehicle Administration in accordance with § 12–303 of the Transportation Article. A donor may make a gift by authorizing that a statement or symbol indicating that the donor has made a gift be included on a donor registry.

An individual may refuse to make an anatomical gift of the individual’s body or part by: A record signed by: The individual; or Subject to subsection (b) of this section, if the individual is physically unable to sign, another individual acting at the direction of the individual; The individual’s will, whether or not the will is admitted to probate or invalidated after the individual’s death; or During a terminal illness of the individual or while the individual is injured, any form of communication addressed to at least two adults, at least one of whom is a disinterested witness. A record signed in accordance with subsection (a)(1)(ii) of this section shall: Be witnessed by at least two adults, at least one of whom is a disinterested witness, who have signed at the request of the individual; and State that the record has been signed and witnessed as provided in item (1) of this subsection. An individual who has made a refusal may amend or revoke the refusal: In a manner for making a refusal provided in subsection (a) of this section; By subsequently making an anatomical gift in accordance with § 4–503 of this subtitle that is inconsistent with the refusal; or By destroying or canceling the record evidencing the refusal, or the portion of the record used to make the refusal, with the intent to revoke the refusal. Except as otherwise provided in § 4–506(h) of this subtitle, in the absence of an express, contrary indication by the individual set forth in the refusal, an individual’s unrevoked refusal to make an anatomical gift of the individual’s body or part bars all other persons from making an anatomical gift of the individual’s body or part.

Except as otherwise provided in subsection (g) of this section and subject to subsection (f) of this section, in the absence of an express, contrary indication by the donor, a person other than the donor is barred from making, amending, or revoking an anatomical gift of a donor’s body or part if the donor made: An anatomical gift of the donor’s body or part under § 4–503 of this subtitle; or An amendment to an anatomical gift of the donor’s body or part under § 4–504 of this subtitle. A donor’s revocation of an anatomical gift of the donor’s body or part under § 4–504 of this subtitle is not a refusal and does not bar another person specified in § 4–501 or § 4–507 of this subtitle from making an anatomical gift of the donor’s body or part under § 4–503 or § 4–508 of this subtitle. If a person other than a donor makes an unrevoked anatomical gift of the donor’s body or part under § 4–503 of this subtitle, or an amendment to an anatomical gift of the donor’s body or part under § 4–504 of this subtitle, another person may not make, amend, or revoke the gift of the donor’s body or part under § 4–508 of this subtitle. A revocation of an anatomical gift of a donor’s body or part under § 4–504 of this subtitle by a person other than the donor does not bar another person from making an anatomical gift of the body or part under § 4–503 or § 4–508 of this subtitle. In the absence of an express, contrary indication by the donor or other person authorized to make an anatomical gift under § 4–503 of this subtitle, an anatomical gift of a part is not a refusal to give another part or a limitation on the making of an anatomical gift of another part at a later time by the donor or another person. In the absence of an express, contrary indication by the donor or other person authorized to make an anatomical gift under § 4–503 of this subtitle, an anatomical gift of a part for one or more of the purposes set forth in § 4–503 of this subtitle is not a limitation on the making of an anatomical gift of the part for any other purpose by the donor or other person under § 4–503 or § 4–508 of this subtitle. If a donor who is an unemancipated minor dies, a reasonably available parent or guardian of the donor may revoke or amend an anatomical gift of the donor’s body or part. If an unemancipated minor who signed a refusal dies, a reasonably available parent or guardian of the minor may revoke the minor’s refusal.

Subject to subsections (b) and (c) of this section and except as prohibited under §§ 4–505 and 4–506 of this subtitle, in accordance with the order of priority listed, a member of one of the following classes of individuals who is reasonably available may make an anatomical gift of a decedent’s body or part for the purpose of transplantation, therapy, research, or education: An agent of the decedent at the time of death who could have made an anatomical gift under § 4–503(b) of this subtitle immediately before the decedent’s death; The persons who were acting as the guardians of the decedent at the time of the death of the decedent; The spouse or domestic partner of the decedent; The adult children of the decedent; The parents of the decedent; The adult siblings of the decedent; The adult grandchildren of the decedent; The grandparents of the decedent; An adult who exhibited special care and concern for the decedent; or Another person having the authority to dispose of the body of the decedent. If there is more than one member of a class listed in subsection (a)(1), (3), (4), (5), (6), (7), or (9) of this section entitled to make an anatomical gift, an anatomical gift may be made by a member of the class unless that member or a person to which the gift may pass under § 4–509 of this subtitle knows of an objection by another member of the class. If an objection to an anatomical gift is known, the gift may be made only by a majority of the members of the class who are reasonably available. A person may not make an anatomical gift if, at the time of the decedent’s death, a person in a prior class under subsection (a) of this section is reasonably available to make or to object to the making of an anatomical gift.

A person authorized to make an anatomical gift under § 4–507 of this subtitle may make an anatomical gift: By a document of gift signed by the person making the gift; or By an oral communication that is electronically recorded or is contemporaneously reduced to a record and signed by the individual receiving the oral communication. Subject to subsection (c) of this section, an anatomical gift by a person authorized under § 4–507 of this subtitle may be amended or revoked orally or in a record by a reasonably available member of a prior class. If more than one member of a prior class is reasonably available, the gift made by a person authorized under § 4–507 of this subtitle may be: Amended only if a majority of the reasonably available members agree to the amendment; or Revoked only if: A majority of the reasonably available members agree to the revocation; or The reasonably available members are equally divided as to whether to revoke the gift. A revocation under subsection (b) of this section is effective only if, before an incision has been made to remove a part from the donor’s body or before invasive procedures have begun to prepare the recipient, the procurement organization, transplant hospital, or physician or technician knows of the revocation.

An anatomical gift may be made to the following persons named in a document of gift: A hospital, an accredited medical school, a dental school, a college or university, an organ procurement organization, the State Anatomy Board, or a nontransplant tissue bank for research, training, or education; Subject to subsection (b) of this section, if the individual is the recipient of the part, an individual designated by the person making the anatomical gift; or An eye bank or a transplant tissue bank. If an anatomical gift to an individual under subsection (a)(2) of this section cannot be transplanted into the individual, the part passes in accordance with subsection (g) of this section in the absence of an express, contrary indication by the person making the anatomical gift. If an anatomical gift of one or more specific parts or of all parts is made in a document of gift that does not name a person described in subsection (a) of this section but identifies the purpose for which an anatomical gift may be used, the following provisions apply: If the part is an eye and the gift is for the purpose of transplantation or therapy, the gift passes to the appropriate eye bank; If the part is tissue and the gift is for the purpose of transplantation or therapy, the gift passes to the appropriate tissue bank; If the part is an organ and the gift is for the purpose of transplantation or therapy, the gift passes to the appropriate organ procurement organization as custodian of the organ; or If the part is an organ, an eye, or tissue and the gift is for the purpose of research or education, the gift passes to the appropriate procurement organization. For the purpose of subsection (c) of this section, if there is more than one purpose of an anatomical gift set forth in the document of gift but the purposes are not set forth in any priority, the gift shall be used: For transplantation or therapy, if suitable; or If the gift cannot be used for transplantation or therapy, for research or education. If an anatomical gift of one or more specific parts is made in a document of gift that does not name a person described in subsection (a) of this section and does not identify the purpose of the gift, the gift passes in accordance with subsection (g) of this section. Except as provided in paragraph (2) of this subsection, if a document of gift specifies only a general intent to make an anatomical gift by words such as “donor”, “organ donor”, or “body donor”, or by a symbol or statement of similar import, the gift passes in accordance with subsection (g) of this section and may be used for transplantation, research, education, or therapy. If a donor registered a document of gift described under paragraph (1) of this subsection before July 1, 2022, the gift may only be used for transplantation or therapy. For purposes of subsections (b), (e), and (f) of this section, the following provisions apply: If the part is an eye, the gift passes to the appropriate eye bank; If the part is tissue, the gift passes to the appropriate tissue bank; and If the part is an organ, the gift passes to the appropriate organ procurement organization as custodian of the organ. Other than an anatomical gift under subsection (a)(2) of this section, an anatomical gift of an organ for transplantation or therapy, research, or education passes to the organ procurement organization as custodian of the organ. If an anatomical gift does not pass in accordance with subsections (a) through (h) of this section, or the decedent’s body or part is not used for transplantation, therapy, research, or education, custody of the body or part passes to the person under obligation to dispose of the body or part. A person may not accept an anatomical gift if the person knows that: The gift was not effectively made under § 4–503 or § 4–508 of this subtitle; or The decedent made a refusal under § 4–505 of this subtitle that was not revoked. For purposes of this subsection, if a person knows that an anatomical gift was made on a document of gift, the person is deemed to know of any amendment or revocation of the gift or any refusal to make an anatomical gift on the same document of gift. Except as otherwise provided in subsection (a)(2) of this section, nothing in this subtitle affects the allocation of organs for transplantation or therapy.

A document of gift need not be delivered during the lifetime of a donor to be effective. On or after the death of an individual, a person in possession of a document of gift or a refusal to make an anatomical gift regarding the individual shall allow examination and copying of the document of gift or refusal by: A person authorized to make or object to the making of the anatomical gift; or A person to which the gift could pass under § 4–509 of this subtitle.

Whenever a hospital refers an individual who is dead or whose death is imminent to a procurement organization to ascertain whether the individual has made an anatomical gift, the organization shall make a reasonable search of any national and local donor registry that exists for the geographical area in which the individual resides. When a hospital refers an individual who is dead or whose death is imminent to a procurement organization, the organization may conduct any reasonable examination necessary to ensure the medical suitability of a part that is or could be the subject of an anatomical gift for transplantation, therapy, research, or education. During the examination period, measures necessary to ensure the medical suitability of a part from a prospective donor: May not be withdrawn unless the hospital or procurement organization knows that the individual expressed a contrary intent; and May be administered, unless it is determined that the administration of those measures would not provide the prospective donor with appropriate end–of–life care consistent with reasonable medical judgment. Unless prohibited by law other than this subtitle, at any time after a donor’s death, the person to which a part passes under § 4–509 of this subtitle may conduct a reasonable examination necessary to ensure the medical suitability of the body or part for its intended purpose. Unless prohibited by law other than this subtitle, an examination under subsection (b) or (c) of this section may include an examination of all medical and dental records of the donor or prospective donor. On the death of a minor who was a donor or had signed a refusal, unless a procurement organization knows that the minor is emancipated, the procurement organization shall conduct a reasonable search for the parents of the minor and provide the parents with an opportunity to revoke or amend the anatomical gift or revoke the refusal. On a referral by a hospital under subsection (a) of this section, a procurement organization shall make a reasonable search for a person listed in § 4–507 of this subtitle having priority to make an anatomical gift on behalf of a prospective donor. If a procurement organization receives information that an anatomical gift to any other person was made, amended, or revoked, the procurement organization shall promptly advise the other person of all relevant information. Subject to §§ 4–509(i) and 4–519 of this subtitle, after the death of the donor, the rights of a person to which a part passes under § 4–509 of this subtitle are superior to the rights of all others with respect to the part. The person to which a part passes under § 4–509 of this subtitle may accept or reject an anatomical gift in whole or in part. Subject to the terms of a document of gift and this subtitle, a person that accepts an anatomical gift of an entire body may allow embalming, burial, or cremation, and the use of remains in a funeral service. If an anatomical gift of a part is made under § 4–509 of this subtitle, on the death of the donor and before embalming, burial, or cremation, the person to which the part passes shall have the part removed without unnecessary mutilation. A physician who attends a decedent at death and a physician who determines the time of a decedent’s death may not participate in the procedures for removing or transplanting a part from the decedent. A physician or technician may remove a donated part from the body of a donor that the physician or technician is qualified to remove. An organ procurement organization may recover a donated body part from the body of a donor on behalf of an eye bank or tissue bank. Each hospital in the State shall enter into an agreement or affiliation with a procurement organization for coordination of procurement and use of anatomical gifts.

Except as provided in subsection (b) of this section, if removal of a part from an individual is intended to occur after the individual’s death, a person may not for valuable consideration knowingly purchase or sell the part for transplantation or therapy. A person that violates paragraph (1) of this subsection is guilty of a felony and on conviction is subject to a fine not exceeding $50,000 or imprisonment not exceeding 5 years or both. A person may charge a reasonable amount of money for the removal, processing, preservation, quality control, storage, transportation, implantation, or disposal of a part. The prohibition in subsection (a) of this section does not apply to blood and plasma. A person may not, in order to obtain financial gain, intentionally falsify, forge, conceal, deface, or obliterate a document of gift, an amendment or revocation of a document of gift, or a refusal. A person who violates paragraph (1) of this subsection is guilty of a felony and on conviction is subject to a fine not exceeding $50,000 or imprisonment not exceeding 5 years or both.

A person that acts in accordance with this subtitle or with the applicable anatomical gift law of another state, or attempts in good faith to do so, is not liable for the act in a civil action, a criminal prosecution, or an administrative proceeding. A person making an anatomical gift or the donor’s estate is not liable for any injury or damage that results from the making or use of the gift. In determining whether an anatomical gift has been made, amended, or revoked under this subtitle, a person may rely on representations of an individual listed in § 4–507(a)(2) through (9) of this subtitle relating to the individual’s relationship to the donor or prospective donor unless the person knows that the representation is untrue.

A document of gift is valid if executed in accordance with: This subtitle; The laws of the state or country where it was executed; or The laws of the state or country where the person making the anatomical gift was domiciled, has a place of residence, or was a national at the time the document of gift was executed. If a document of gift is valid under this section, the law of this State governs the interpretation of the document of gift. A person may presume that a document of gift or an amendment of an anatomical gift is valid unless that person knows that it was not validly executed or was revoked.

In this section, “qualified nonprofit entity” means a procurement organization exempt from taxation under § 501(c)(3) of the Internal Revenue Code or an entity exempt from taxation under § 501(c)(3) of the Internal Revenue Code that actively functions in a supporting relationship to one or more procurement organizations if the procurement organization or other entity has a board of directors whose members are experienced in: Organ, tissue, and eye donation; Working with donors and donor families; and Educating the public about the importance of the process of organ, tissue, and eye donation. The Secretary of Health shall contract with a qualified nonprofit entity for the establishment, maintenance, and operation of a donor registry. The Secretary of Health shall use funds from the Organ and Tissue Donation Awareness Fund as required under § 13–901 of the Health – General Article and any other funds as may be appropriate to compensate the nonprofit entity contracted with under paragraph (1) of this subsection for the reasonable cost of establishing, maintaining, and operating the donor registry, including the reasonable cost of public education programs to increase public awareness about the existence and purpose of the registry and organ, tissue, and eye donation. The Motor Vehicle Administration shall cooperate with the qualified nonprofit entity contracted with under subsection (b)(1) of this section for the purpose of transferring to the donor registry all relevant information regarding a donor’s making, amending of, or revoking of an anatomical gift. A donor registry shall be accessible 24 hours a day and 7 days a week to allow: A donor to include on the donor registry a statement or symbol that the donor has made or amended an anatomical gift; A donor to revoke an anatomical gift; or A procurement organization to obtain relevant information on the donor registry to determine, at the death or imminent death of a donor or a prospective donor, whether the donor or prospective donor has made, amended, or revoked an anatomical gift. Personally identifiable information on a donor registry about a donor or prospective donor may not be used or disclosed without the express consent of the donor, prospective donor, or person that made the anatomical gift for any purpose other than to determine, at the death or imminent death of the donor or prospective donor, whether the donor or prospective donor has made or amended an anatomical gift. This section does not prohibit a person from creating or maintaining a donor registry that is not established by or under contract with the State. A registry that is not established by or under contract with the State shall comply with subsections (d) and (e) of this section.

In this section, “advance health care directive” means a power of attorney for health care or a record signed or authorized by a prospective donor in accordance with §§ 5–601 through 5–618 of the Health – General Article containing the prospective donor’s direction concerning a health–care decision for the prospective donor. If a prospective donor has a declaration or advance health care directive and the terms of the declaration or directive and the express or implied terms of a potential anatomical gift are in conflict with regard to the administration of measures necessary to ensure the medical suitability of a part for transplantation or therapy: The prospective donor’s attending physician and prospective donor shall confer to resolve the conflict; or If the prospective donor is incapable of resolving the conflict, an agent acting under the prospective donor’s declaration or directive shall act for the donor to resolve the conflict. If there is not an agent or the agent is not reasonably available, another person authorized by a law other than this subtitle to make health care decisions on behalf of the prospective donor shall act for the donor to resolve the conflict. Information relevant to the resolution of the conflict under this subsection may be obtained from the appropriate procurement organization and any other person authorized to make an anatomical gift for the prospective donor under § 4–507 of this subtitle. Before resolution of a conflict under this subsection, measures necessary to ensure the medical suitability of a part from a prospective donor may be administered unless it is determined that the administration of those measures would not provide the prospective donor with appropriate end–of–life care, consistent with reasonable medical judgment. If the conflict under this subsection is not resolved expeditiously, the direction of the declaration or advance health care directive controls.

OCME and procurement organizations shall cooperate with each other to maximize the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, research, or education. If OCME receives notice from a procurement organization that an anatomical gift might be available or was made with respect to a decedent whose body or part is under the jurisdiction of OCME and a postmortem examination is going to be performed, unless OCME denies recovery in accordance with § 4–519 of this subtitle, OCME or OCME’s designee shall conduct the postmortem examination of the body or part in a manner and within a period compatible with its preservation for the purposes of the gift. A part may not be removed from the body of a decedent under the jurisdiction of OCME for transplantation, therapy, research, or education unless the part is the subject of an anatomical gift or an authorization given by OCME in accordance with subsection (d) of this section. The body of a decedent under the jurisdiction of OCME may not be delivered to a person for research or education unless the body is the subject of an anatomical gift or an authorization given by OCME in accordance with subsection (d) of this section. This subsection does not preclude OCME from performing a postmortem examination of the body or part of a decedent under the jurisdiction of OCME for the purposes of education, training, and research required by OCME. The Chief Medical Examiner, the deputy chief medical examiner, or an assistant medical examiner may provide a part on the request of a procurement organization under the following conditions: The medical examiner has charge of a decedent who may provide a suitable part for transplant; A reasonable, unsuccessful search has been made by the procurement organization as required by § 4–512(f) of this subtitle to contact the persons authorized under § 4–507 of this subtitle to make an anatomical gift; No objection by the persons authorized under § 4–507 of this subtitle to make an anatomical gift is known by the medical examiner; and The provision of the part for transplant will not interfere with the subsequent course of an investigation or autopsy. If the Chief Medical Examiner has obtained a written or verbal statement from the procurement organization that a reasonable, unsuccessful search was conducted prior to the removal of a part for transplantation, the Chief Medical Examiner, the deputy chief medical examiner, an assistant chief medical examiner, and the procurement organization are not civilly liable if a person authorized under § 4–507 of this subtitle to make an anatomical gift is subsequently located and contends that the authorization of that person was required to make the gift. A verbal statement under subparagraph (1) of this paragraph shall be documented in the medical record of the decedent.

On request of a procurement organization, OCME shall release to the procurement organization the name, contact information, and available medical and social history of a decedent whose body is under the jurisdiction of OCME. If a body or part of a decedent is medically suitable for transplantation, therapy, research, or education, OCME shall release postmortem examination results to the procurement organization that made a request under paragraph (1) of this subsection. If relevant to transplantation or therapy, a procurement organization may make a subsequent disclosure of the postmortem examination results or other information received from OCME. OCME may conduct a postmortem examination by reviewing medical records, laboratory test results, X–rays, other diagnostic results, and other information that OCME determines may be relevant to the examination. A person that has information requested by OCME in accordance with subsection (b) of this section, shall provide the information as expeditiously as possible to allow OCME to conduct the postmortem examination within a period compatible with the preservation of parts for the purpose of transplantation, therapy, research, or education. OCME and a procurement organization shall cooperate in the timely removal of a part from a decedent if: An anatomical gift has been or might be made of a part of the decedent whose body is under the jurisdiction of OCME and a postmortem examination is not required; or OCME determines that a postmortem examination is required but that the recovery of the part that is the subject of the anatomical gift will not interfere with the examination. OCME and procurement organizations shall enter into an agreement setting forth protocols and procedures to govern relations between the parties when an anatomical gift of a part from a decedent under the jurisdiction of OCME has been or might be made, but OCME believes that the recovery of the part could interfere with the postmortem examination into the decedent’s cause or manner of death. Decisions regarding the recovery of organs, tissue, and eyes under this subsection shall be made in accordance with the agreement described in paragraph (1) of this subsection. If OCME denies recovery of an anatomical gift, the procurement organization may request that OCME reconsider the denial and allow the recovery to proceed. The parties shall evaluate the effectiveness of the protocols and procedures agreed to under this subsection at regular intervals, but no less frequently than every 2 years. If OCME or a designee allows recovery of a part under subsection (d) or (e) of this section, on request, the procurement organization shall cause the physician or technician who removes the part to provide OCME with a record describing the condition of the part, a biopsy, a photograph, and any other information and observations that would assist in the postmortem examination. If OCME or a designee is required to be present at a removal procedure under subsection (e) of this section, on request, the procurement organization requesting the recovery of the part shall reimburse OCME or a designee for the additional costs incurred in complying with subsection (f) of this section.

In applying and construing this subtitle, which is a uniform act, consideration shall be given to the need to promote uniformity of the law with respect to its subject matter among states that enact the provisions of this subtitle.

This subtitle modifies, limits, and supersedes the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. Section 7001 et seq., but does not modify, limit, or supersede Section 101(a) of that act, 15 U.S.C. Section 7001 et seq., or authorize electronic delivery of any of the notices described in Section 103(b) of that act, 15 U.S.C. Section 7003(b).

This subtitle may be cited as the Maryland Revised Uniform Anatomical Gift Act.