According to the law, we are all donors unless we choose to opt out.
Requirements for obtaining donor organs from the deceased:
1. Obtaining organs from deceased donors for therapeutic purposes may be performed if the following requirements are met:
a) That the deceased of whom is intended to obtain organs, has not left an express record of his opposition to the fact that after his death the organ procurement is performed. Said opposition, as well as its agreement if it wishes to express it, may refer to all types of organs or only to some of them and shall be respected.
In the case of minors or incapacitated persons, the opposition may be recorded by those who had held their legal representation during their lifetime, in accordance with the provisions of the civil legislation.
b) Whenever it is intended to proceed to obtain organs from deceased donors in an authorized centre, the person in charge of the hospital transplant coordination, or the person in whom he delegates, must perform the following pertinent checks on the will of the deceased:
1. Investigate if the donor made his will clear to any of his relatives, or to the professionals who have attended him in the health centre, through the annotations that they have been able to make in the clinical record, or in the means provided. in the current legislation.
2. Examine the documentation and personal belongings that the deceased had with him.
Provided that circumstances do not prevent it, it should be provided to family members present in the health centre information about the need, nature and circumstances of obtaining, restoration, conservation or mortuary health practices.
2. Obtaining organs from deceased persons can only be done after a diagnosis and certification of death made in accordance with the provisions of this Royal Decree and in particular in Annex I, the ethical requirements, scientific advances in the matter and medical practice, generally accepted.
The professionals who diagnose and certify the death must be physicians with the appropriate qualification for this purpose, other than those who have to intervene in the extraction or transplantation and will not be subject to the instructions of the latter.
The death of the individual may be certified after confirming the irreversible cessation of circulatory and respiratory functions or the irreversible cessation of brain functions. The time at which the diagnosis of death was completed will be recorded as the patient’s time of death.
3. The irreversible cessation of circulatory and respiratory functions will be recognized by an appropriate clinical examination after an appropriate period of observation. The clinical diagnostic criteria, the observation periods, as well as the confirmatory tests that are required according to medical circumstances, shall conform to the protocols included in Annex I.
In the case expressed in the previous paragraph, and for the purposes of the death certificate and the obtaining of organs, the existence of a death certificate issued by a doctor different from the one involved in the extraction or transplantation will be required.
4. The irreversible cessation of brain functions, that is, the verification of an unreactive coma of known structural and aetiology irreversible character, will be recognized by an adequate clinical examination after an appropriate period of observation. The clinical diagnostic criteria, the observation periods, as well as the confirmatory tests that are required according to medical circumstances, shall conform to the protocols included in Annex I.
In the case expressed in the previous paragraph, and for the purposes of the death certificate and the obtaining of organs, the existence of a death certificate signed by three doctors, who must include a neurologist or neurosurgeon and the Chief of Service of the medical unit where you are admitted, or your substitute. Under no circumstances may said physicians be part of the extractor or transplant equipment of the organs.
5. In cases of accidental death, as well as when a judicial investigation is underway, before obtaining the organs, the authorization of the corresponding judge must be obtained, which, after a forensic doctor’s report, must be granted as long as the judge is not hindered. result of the instruction of criminal proceedings.
In cases of death diagnosed by circulatory and respiratory criteria that require judicial authorization, in order to proceed with manoeuvres to maintain the viability of the organs and with the preservation manoeuvres, action will be taken in accordance with the provisions of Annex I.
The request for obtaining organs must be accompanied by the death certificate referred to in paragraphs 3 or 4 of this article, as appropriate, together with a medical report explaining the personal circumstances and hospital admission, and a supporting sheet, signed by the person in charge of the hospital transplant coordination or the person in whom he delegates, that the doctor or doctors who sign the death certificate are different from the one who is going to perform the extraction of organs and / or the transplant.
6. On the part of the person in charge of the hospital transplant coordination or person to whom he delegates, as determined in the authorization of the centre, a document must be issued stating:
a) That the checks have been made on the will of the deceased, or of the persons who hold their legal representation.
b) That the relatives have been provided with the necessary information about the obtaining process, provided that the objective circumstances have not prevented it, stating the latter situation should it occur.
c) That death has been verified and certified and the death certificate is attached to the authorization document.
d) In the situations of death contemplated in section 5, which has the authorization of the corresponding judge.
e) That the hospital centre where the procurement is to be carried out is authorized for this purpose and that said authorization is in force.
f) The organs for which the obtaining is not authorized, taking into account the restrictions that the donor may have established.
g) The name, surnames and professional qualifications of the doctors who have certified the death, and that none of these physicians is part of the extractor or transplant team.
7. Deceased donors will be properly characterized, in accordance with the provisions of article 21.
8. Once the body of the deceased donor has been restored after obtaining it, access or visit of relatives and relatives should be allowed, if requested.
3. The following are excluded from the scope of this royal decree:
a) the organs, when their extraction has as its exclusive purpose the performance of studies or clinical analyzes, or other diagnostic or therapeutic purposes;
b) blood and its derivatives;
c) tissues and cells and their derivatives, except for vascularized composite tissues;
d) the gametes;
e) human embryos and fetuses;
f) hair, nails, placenta and other human waste products;
g) the performance of clinical autopsies, in accordance with the provisions of Law 29/1980, of June 21, on clinical autopsies, and Royal Decree 2230/1982, of June 18, on clinical autopsies;
h) the donation of one’s own body for use in studies, teaching or research;
i) the xenotransplant.
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