# Title 23 — Health and Safety

## Chapter 23-06.6 — Uniform Anatomical Gift Act

### § 23-06.6-01. Definitions.

As used in this chapter, unless the context requires otherwise:
1. "Adult" means an individual who is eighteen years of age or older.
2. "Agent" means an individual:
a. Authorized to make health care decisions on the principal's behalf by a power of
attorney for health care; or
b. Expressly authorized to make an anatomical gift on the principal's behalf by any
other record signed by the principal.
3. "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.
4. "Decedent" means a deceased individual whose body or part is or may be the source
of an anatomical gift. The term includes a stillborn infant and, subject to restrictions
imposed by law other than this chapter, a fetus.
5. "Disinterested witness" means a witness other than the spouse, child, parent, sibling,
grandchild, grandparent, or guardian of the individual who makes, amends, revokes, or
refuses to make an anatomical gift or another adult who exhibited special care and
concern for the individual. The term does not include a person to which an anatomical
gift could pass under section 23-06.6-10.
6. "Document of gift" means a donor card or other record used to make an anatomical
gift. The term includes a statement or symbol on a driver's license, identification card,
or donor registry.
7. "Donor" means an individual whose body or part is the subject of an anatomical gift.
8. "Donor registry" means a database that contains records of anatomical gifts and
amendments to or revocations of anatomical gifts.
9. "Driver's license" means a license or permit issued by the department of transportation
to operate a vehicle regardless of whether conditions are attached to the license or
permit.
10. "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.
11. "Guardian" means a person appointed by a court to make decisions regarding the
support, care, education, health, or welfare of an individual. The term does not include
a guardian ad litem.
12. "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.
13. "Identification card" means an identification card issued by the department of
transportation.
14. "Know" means to have actual knowledge.
15. "Minor" means an individual who is under eighteen years of age.
16. "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.
17. "Parent" means a parent whose parental rights have not been terminated.
18. "Part" means an organ, an eye, or tissue of a human being. The term does not include
the whole body.
19. "Physician" means an individual authorized to practice medicine or osteopathy under
the law of any state.
20. "Procurement organization" means an eye bank, an organ procurement organization,
or a tissue bank.
21. "Prospective donor" means an individual who is dead or near death and has been
determined by a procurement organization to have a part that could be medically
suitable for transplantation, therapy, research, or education. The term does not include
an individual who has made a refusal.

22. "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.
23. "Recipient" means an individual into whose body a decedent's part has been or is
intended to be transplanted.
24. "Record" means information that is inscribed on a tangible medium or that is stored in
an electronic or other medium and is retrievable in perceivable form.
25. "Refusal" means an intention not to make an anatomical gift of an individual's body or
part expressed by the individual in accordance with section 23-06.6-06 or which
expressly states an intent to bar other persons from making an anatomical gift of an
individual's body or part.
26. "Sign" means, with the present intent to authenticate or adopt a record:
a. To execute or adopt a tangible symbol; or
b. To attach to or logically associate with the record an electronic symbol, sound, or
process.
27. "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. The term includes an enucleator.
28. "Tissue" means a portion of the human body other than an organ or an eye. The term
does not include blood unless the blood is donated for the purpose of research or
education.
29. "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.
30. "Transplant hospital" means a hospital that furnishes organ transplants and other
medical and surgical specialty services required for the care of transplant patients.
### § 23-06.6-02. Applicability.

This chapter applies to an anatomical gift or amendment to, revocation of, or refusal to
make an anatomical gift, whenever made.
### § 23-06.6-03. Who may make an anatomical gift before donor's death.

Subject to section 23-06.6-07, an anatomical gift of a donor's body or part may be made
during the life of the donor for the purpose of transplantation, therapy, research, or education in
the manner provided in section 23-06.6-04 by:
1. The donor, if the donor is an adult or if the donor is a minor and is:
a. Emancipated; or
b. Authorized under state law to apply for a driver's license because the donor is at
least fourteen years of age;
2. An agent of the donor, unless the power of attorney for health care or other record
prohibits the agent from making an anatomical gift;
3. A parent of the donor, if the donor is an unemancipated minor; or
4. The donor's guardian.
### § 23-06.6-04. Manner of making anatomical gift before donor's death.

1. A donor may make an anatomical gift:
a. 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;
b. In a will;
c. During a terminal illness or 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
d. As provided in subsection 2.

2. A donor or other person authorized to make an anatomical gift under section
other person making the gift or by authorizing that a statement or symbol indicating
that the donor has made an anatomical gift be included on a donor registry. If the
donor or other person 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 must:
a. 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
b. State that it has been signed and witnessed as provided in subdivision a.
3. Revocation, suspension, expiration, or cancellation of a driver's license or identification
card upon which an anatomical gift is indicated does not invalidate the gift.
4. An anatomical gift made by will takes effect upon the donor's death whether or not the
will is probated. Invalidation of the will after the donor's death does not invalidate the
gift.
### § 23-06.6-05. Amending or revoking anatomical gift before donor's death.

1. Subject to section 23-06.6-07, a donor or other person authorized to make an
anatomical gift under section 23-06.6-03 may amend or revoke an anatomical gift by:
a. A record signed by:
(1) The donor;
(2) The other person; or
(3) Subject to subsection 2, another individual acting at the direction of the
donor or the other person if the donor or other person is physically unable to
sign; or
b. A later-executed document of gift that amends or revokes a previous anatomical
gift or portion of an anatomical gift, either expressly or by inconsistency.
2. A record signed pursuant to paragraph 3 of subdivision a of subsection 1 must:
a. 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
b. State that it has been signed and witnessed as provided in subdivision a.
3. Subject to section 23-06.6-07, a donor or other person authorized to make an
anatomical gift under section 23-06.6-03 may revoke an 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.
4. A donor may amend or revoke an anatomical gift that was not made in a will by any
form of communication during a terminal illness or injury addressed to at least two
adults, at least one of whom is a disinterested witness.
5. A donor who makes an anatomical gift in a will may amend or revoke the gift in the
manner provided for amendment or revocation of wills or as provided in subsection 1.
### § 23-06.6-06. Refusal to make anatomical gift - Effect of refusal.

1. An individual may refuse to make an anatomical gift of the individual's body or part by:
a. A record signed by:
(1) The individual; or
(2) Subject to subsection 2, another individual acting at the direction of the
individual if the individual is physically unable to sign;
b. The individual's will regardless of whether the will is admitted to probate or
invalidated after the individual's death; or
c. Any form of communication made by the individual during the individual's terminal
illness or injury addressed to at least two adults, at least one of whom is a
disinterested witness.
2. A record signed pursuant to paragraph 2 of subdivision a of subsection 1 must:
a. 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
b. State that it has been signed and witnessed as provided in subdivision a.
3. An individual who has made a refusal may amend or revoke the refusal:

a. In the manner provided in subsection 1 for making a refusal;
b. By subsequently making an anatomical gift pursuant to section 23-06.6-04 which
is inconsistent with the refusal; or
c. 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.
4. Except as otherwise provided in subsection 8 of section 23-06.6-07, 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.
### § 23-06.6-07. Preclusive effect of anatomical gift, amendment, or revocation.

1. Except as otherwise provided in subsection 7 and subject to subsection 6, 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 section
section 23-06.6-05.
2. A donor's revocation of an anatomical gift of the donor's body or part under section
under section 23-06.6-04 or 23-06.6-09.
3. If a person other than the donor makes an unrevoked anatomical gift of the donor's
body or part under section 23-06.6-04 or an amendment to an anatomical gift of the
donor's body or part under section 23-06.6-05, another person may not make, amend,
or revoke the gift of the donor's body or part under section 23-06.6-09.
4. A revocation of an anatomical gift of a donor's body or part under section 23-06.6-05
by a person other than the donor does not bar another person from making an
anatomical gift of the body or part under section 23-06.6-04 or 23-06.6-09.
5. In the absence of an express, contrary indication by the donor or other person
authorized to make an anatomical gift under section 23-06.6-03, an anatomical gift of a
part is neither a refusal to give another part nor a limitation on the making of an
anatomical gift of another part at a later time by the donor or another person.
6. In the absence of an express, contrary indication by the donor or other person
authorized to make an anatomical gift under section 23-06.6-03, an anatomical gift of a
part for one or more of the purposes set forth in section 23-06.6-03 is not a limitation
on the making of an anatomical gift of the part for any of the other purposes by the
donor or any other person under section 23-06.6-04 or 23-06.6-09.
7. If a donor who is an unemancipated minor dies, a parent of the donor who is
reasonably available may revoke or amend an anatomical gift of the donor's body or
part.
8. If an unemancipated minor who signed a refusal dies, a parent of the minor who is
reasonably available may revoke the minor's refusal.
### § 23-06.6-08. Who may make anatomical gift of decedent's body or part.

1. Subject to subsections 2 and 3 and unless barred by section 23-06.6-06 or 23-06.6-07,
an anatomical gift of a decedent's body or part for the purpose of transplantation,
therapy, research, or education may be made by any member of the following classes
of persons who is reasonably available, in the order of priority listed:
a. An agent of the decedent at the time of death who could have made an
anatomical gift under subsection 2 of section 23-06.6-03 immediately before the
decedent's death;
b. The spouse of the decedent;
c. Adult children of the decedent;
d. Parents of the decedent;
e. Adult siblings of the decedent;
f. Adult grandchildren of the decedent;

g. Grandparents of the decedent;
h. An adult who exhibited special care and concern for the decedent;
i. The persons who were acting as the guardians of the decedent at the time of
death; and
j. Any other person having the authority to dispose of the decedent's body.
2. If there is more than one member of a class listed in subdivision a, c, d, e, f, g, or i of
subsection 1 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
section 23-06.6-10 knows of an objection by another member of the class. If an
objection is known, the gift may be made only by a majority of the members of the
class who are reasonably available.
3. 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 1 is reasonably available to make or to object
to the making of an anatomical gift.
### § 23-06.6-09. Manner of making, amending, or revoking anatomical gift of decedent's

body or part.
1. A person authorized to make an anatomical gift under section 23-06.6-08 may make
an anatomical gift by a document of gift signed by the person making the gift or by that
person's oral communication that is electronically recorded or is contemporaneously
reduced to a record and signed by the individual receiving the oral communication.
2. Subject to subsection 3, an anatomical gift by a person authorized under section
class who is reasonably available. If more than one member of the prior class is
reasonably available, the gift made by a person authorized under section 23-06.6-08
may be:
a. Amended only if a majority of the reasonably available members agree to the
amending of the gift; or
b. Revoked only if a majority of the reasonably available members agree to the
revoking of the gift or if they are equally divided as to whether to revoke the gift.
3. A revocation under subsection 2 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.
### § 23-06.6-10. Persons that may receive anatomical gift - Purpose of anatomical gift.

1. An anatomical gift may be made to the following persons named in the document of
gift:
a. A hospital; accredited medical school, dental school, college, or university; organ
procurement organization; or other appropriate person for research or education;
b. Subject to subsection 2, an individual designated by the person making the
anatomical gift if the individual is the recipient of the part; or
c. An eye bank or tissue bank.
2. If an anatomical gift to an individual under subdivision b of subsection 1 cannot be
transplanted into the individual, the part passes in accordance with subsection 7 in the
absence of an express, contrary indication by the person making the anatomical gift.
3. 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 1 but identifies the
purpose for which an anatomical gift may be used, the following rules apply:
a. 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.
b. If the part is tissue and the gift is for the purpose of transplantation or therapy, the
gift passes to the appropriate tissue bank.
c. 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.

d. 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.
4. For the purpose of subsection 3, 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 must be used for transplantation or therapy, if suitable. If the gift cannot be
used for transplantation or therapy, the gift may be used for research or education.
5. 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 1 and does not identify the purpose
of the gift, the gift may be used only for transplantation or therapy, and the gift passes
in accordance with subsection 7.
6. 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 may be used only for transplantation or therapy, and the gift
passes in accordance with subsection 7.
7. For purposes of subsections 2, 5, and 6 the following rules apply:
a. If the part is an eye, the gift passes to the appropriate eye bank.
b. If the part is tissue, the gift passes to the appropriate tissue bank.
c. If the part is an organ, the gift passes to the appropriate organ procurement
organization as custodian of the organ.
8. An anatomical gift of an organ for transplantation or therapy, other than an anatomical
gift under subdivision b of subsection 1, passes to the organ procurement organization
as custodian of the organ.
9. If an anatomical gift does not pass pursuant to subsection 1, 2, 3, 4, 5, 6, 7, or 8 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.
10. A person may not accept an anatomical gift if the person knows that the gift was not
effectively made under section 23-06.6-04 or 23-06.6-09 or if the person knows that
the decedent made a refusal under section 23-06.6-06 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.
11. Except as otherwise provided in subdivision b of subsection 1, nothing in this chapter
affects the allocation of organs for transplantation or therapy.
### § 23-06.6-11. Search and notification.

1. The following persons shall make a reasonable search of an individual who the person
reasonably believes is dead or near death for a document of gift or other information
identifying the individual as a donor or as an individual who made a refusal:
a. A law enforcement officer, firefighter, paramedic, or other emergency rescuer
finding the individual; and
b. If no other source of the information is immediately available, a hospital, as soon
as practical after the individual's arrival at the hospital.
2. If a document of gift or a refusal to make an anatomical gift is located by the search
required by subdivision a of subsection 1 and the individual or deceased individual to
whom it relates is taken to a hospital, the person responsible for conducting the search
shall send the document of gift or refusal to the hospital.
3. A person is not subject to criminal or civil liability for failing to discharge the duties
imposed by this section but may be subject to administrative sanctions.
### § 23-06.6-12. Delivery of document of gift not required - Right to examine.

1. A document of gift need not be delivered during the donor's lifetime to be effective.
2. Upon or after an individual's death, a person in possession of a document of gift or a
refusal to make an anatomical gift with respect to 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 an anatomical gift with respect to the individual or by a person
to which the gift could pass under section 23-06.6-10.
### § 23-06.6-13. Rights and duties of procurement organization and others.

1. When a hospital refers an individual at or near death to a procurement organization,
the organization shall make a reasonable search of the records of the department of
transportation and any donor registry that it knows exists for the geographical area in
which the individual resides to ascertain whether the individual has made an
anatomical gift.
2. A procurement organization must be allowed reasonable access to information in the
records of the department of transportation to ascertain whether an individual at or
near death is a donor.
3. When a hospital refers an individual at or near death 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 from a donor or a prospective donor.
During the examination period, measures necessary to ensure the medical suitability
of the part may not be withdrawn unless the hospital or procurement organization
knows that the individual expressed a contrary intent or the measures are contrary to
reasonable medical standards.
4. Unless prohibited by law other than this chapter, at any time after a donor's death, the
person to which a part passes under section 23-06.6-10 may conduct any reasonable
examination necessary to ensure the medical suitability of the body or part for its
intended purpose.
5. Unless prohibited by law other than this chapter, an examination under subsection 3 or
4 may include an examination of all medical and dental records of the donor or
prospective donor.
6. Upon the death of a minor who was a donor or had signed a refusal, unless a
procurement organization knows 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.
7. Upon referral by a hospital under subsection 1, a procurement organization shall make
a reasonable search for any person listed in section 23-06.6-08 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, it shall promptly advise the other person of all relevant information.
8. Subject to subsection 9 of section 23-06.6-10 and section 23-06.6-22, the rights of the
person to which a part passes under section 23-06.6-10 are superior to the rights of all
others with respect to the part. The person may accept or reject an anatomical gift in
whole or in part. Subject to the terms of the document of gift and this chapter, a person
that accepts an anatomical gift of an entire body may allow embalming, burial or
cremation, whole-body donation to a school of medicine, and use of remains in a
funeral service. If the gift is of a part, the person to which the part passes under
section 23-06.6-10, upon the death of the donor and before embalming, burial, whole-
body donation to a school of medicine, or cremation, shall cause the part to be
removed without unnecessary mutilation.
9. Neither the physician who attends the decedent at death nor the physician who
determines the time of the decedent's death may participate in the procedures for
removing or transplanting a part from the decedent.
10. A physician or technician may remove a donated part from the body of a donor which
the physician or technician is qualified to remove.
### § 23-06.6-14. Coordination of procurement and use.

Each hospital in this state shall enter into agreements or affiliations with procurement
organizations for coordination of procurement and use of anatomical gifts.

### § 23-06.6-15. Sale or purchase of parts prohibited - Penalty.

1. Except as otherwise provided in subsection 2, a person that for valuable consideration
knowingly purchases or sells a part for transplantation or therapy if removal of a part
from an individual is intended to occur after the individual's death commits a class B
misdemeanor.
2. A person may charge a reasonable amount for the removal, processing, preservation,
quality control, storage, transportation, implantation, or disposal of a part.
### § 23-06.6-16. Other prohibited act - Penalty.

A person that, in order to obtain a financial gain, intentionally falsifies, forges, conceals,
defaces, or obliterates a document of gift, an amendment or revocation of a document of gift, or
a refusal commits a class B misdemeanor.
### § 23-06.6-17. Immunity.

1. A person that acts in accordance with this chapter 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, criminal prosecution, or administrative proceeding.
2. Neither the person making an anatomical gift nor the donor's estate is liable for any
injury or damage that results from the making or use of the gift.
3. In determining whether an anatomical gift has been made, amended, or revoked under
this chapter, a person may rely upon representations of an individual listed in
subdivision b, c, d, e, f, g, or h of subsection 1 of section 23-06.6-08 relating to the
individual's relationship to the donor or prospective donor unless the person knows
that the representation is untrue.
### § 23-06.6-18. Law governing validity - Choice of law as to execution of document of gift

- Presumption of validity.
1. A document of gift is valid if executed in accordance with:
a. This chapter;
b. The laws of the state or country where the document of gift was executed; or
c. 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.
2. If a document of gift is valid under this section, the law of this state governs the
interpretation of the document of gift.
3. A person may presume that a document of gift or amendment of an anatomical gift is
valid unless that person knows that it was not validly executed or was revoked.
### § 23-06.6-19. Donor registry.

1. The department of health and human services may establish or contract for the
establishment of a donor registry.
2. The department of transportation shall cooperate with a person that administers any
donor registry that this state establishes, contracts for, or recognizes for the purpose of
transferring to the donor registry all relevant information regarding a donor's making,
amendment to, or revocation of an anatomical gift.
3. A donor registry must:
a. Allow a donor or other person authorized under section 23-06.6-03 to include on
the donor registry a statement or symbol that the donor has made, amended, or
revoked an anatomical gift;
b. Be accessible to a procurement organization to allow it to obtain relevant
information on the donor registry to determine, at or near death of the donor or a
prospective donor, whether the donor or prospective donor has made, amended,
or revoked an anatomical gift; and
c. Be accessible for purposes of subdivisions a and b seven days a week on a
twenty-four-hour basis.

4. 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 or near death of the donor or prospective donor, whether the donor or
prospective donor has made, amended, or revoked an anatomical gift.
5. This section does not prohibit any person from creating or maintaining a donor registry
that is not established by or under contract with the state. Any such registry must
comply with subsections 3 and 4.
### § 23-06.6-20. Effect of anatomical gift on advance health care directive.

1. In this section:
a. "Advance health care directive" means a health care directive under chapter
23-06.5, a power of attorney for health care, or a record signed or authorized by a
prospective donor containing the prospective donor's direction concerning a
health care decision for the prospective donor.
b. "Declaration" means a record signed by a prospective donor specifying the
circumstances under which a life support system may be withheld or withdrawn
from the prospective donor.
c. "Health care decision" means any decision regarding the health care of the
prospective donor.
2. 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.
If the prospective donor is incapable of resolving the conflict, an agent acting under the
prospective donor's declaration or directive or, if none or the agent is not reasonably
available, another person authorized by law other than this chapter to make health
care decisions on behalf of the prospective donor shall act for the donor to resolve the
conflict. If involved in resolving the conflict, the agent or other person authorized by
law shall make the decision in accordance with the agent's or person's knowledge of
the prospective donor's wishes and religious or moral beliefs as stated orally or as
contained in the declaration or advance health care directive. The conflict must be
resolved as expeditiously as possible. If the conflict is not resolved expeditiously, the
direction of the declaration or advance directive controls. Information relevant to the
resolution of the conflict may be obtained from the appropriate procurement
organization and any other person authorized to make an anatomical gift for the
prospective donor under section 23-06.6-08. Before resolution of the conflict,
measures necessary to ensure the medical suitability of the part may not be withheld
or withdrawn from the prospective donor if withholding or withdrawing the measures is
not contrary to reasonable medical standards.
### § 23-06.6-21. Cooperation between coroner or medical examiner and a procurement

organization.
1. A coroner or medical examiner shall cooperate with procurement organizations to
maximize the opportunity to recover anatomical gifts for the purpose of transplantation,
therapy, research, or education.
2. If a coroner or medical examiner receives notice from a procurement organization that
an anatomical gift might be available or was made with respect to a decedent whose
body is under the jurisdiction of the coroner or medical examiner and a post-mortem
examination is going to be performed, unless the coroner or medical examiner denies
recovery in accordance with section 23-06.6-22, the coroner or medical examiner or
designee of the coroner or medical examiner shall conduct a post-mortem examination
of the body or the part in a manner and within a period compatible with its preservation
for the purposes of the gift.

3. A part may not be removed from the body of a decedent under the jurisdiction of a
coroner or medical examiner for transplantation, therapy, research, or education
unless the part is the subject of an anatomical gift. The body of a decedent under the
jurisdiction of the coroner or medical examiner may not be delivered to a person for
research or education unless the body is the subject of an anatomical gift. This
subsection does not preclude a coroner or medical examiner from performing the
medicolegal investigation upon the body or parts of a decedent under the jurisdiction
of the coroner or medical examiner.
### § 23-06.6-22. Facilitation of anatomical gift from decedent whose body is under

jurisdiction of coroner or medical examiner.
1. Upon request of a procurement organization, a coroner or medical examiner 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 the
coroner or medical examiner. If the decedent's body or part is medically suitable for
transplantation, therapy, research, or education, the coroner or medical examiner shall
release post-mortem examination results to the procurement organization. The
procurement organization may make a subsequent disclosure of the post-mortem
examination results or other information received from the coroner or medical
examiner only if relevant to transplantation or therapy.
2. The coroner or medical examiner may conduct a medicolegal examination by
reviewing all medical records, laboratory test results, x-rays, other diagnostic results,
and other information that any person possesses about a donor or prospective donor
whose body is under the jurisdiction of the coroner or medical examiner which the
coroner or medical examiner determines may be relevant to the investigation.
3. A person that has any information requested by a coroner or medical examiner
pursuant to subsection 2 shall provide that information as expeditiously as possible to
allow the coroner or medical examiner to conduct the medicolegal investigation within
a period compatible with the preservation of parts for the purpose of transplantation,
therapy, research, or education.
4. If an anatomical gift has been or might be made of a part of a decedent whose body is
under the jurisdiction of the coroner or medical examiner and a post-mortem
examination is not required, or the coroner or medical examiner determines that a
post-mortem examination is required but that the recovery of the part that is the
subject of an anatomical gift will not interfere with the examination, the coroner or
medical examiner and procurement organization shall cooperate in the timely removal
of the part from the decedent for the purpose of transplantation, therapy, research, or
education.
5. If an anatomical gift of a part from the decedent under the jurisdiction of the coroner or
medical examiner has been or might be made, but the coroner or medical examiner
initially believes that the recovery of the part could interfere with the post-mortem
investigation into the decedent's cause or manner of death, the coroner or medical
examiner shall consult with the procurement organization or physician or technician
designated by the procurement organization about the proposed recovery. The
procurement organization shall provide the coroner or medical examiner with all
information the organization has which could relate to the cause or manner of the
decedent's death. After consultation, the coroner or medical examiner may allow the
recovery.
6. Following the consultation under subsection 5, in the absence of mutually agreed-upon
protocols to resolve conflict between the coroner or medical examiner and the
procurement organization, if the coroner or medical examiner intends to deny recovery
of an organ for transplantation, the coroner or medical examiner or designee of the
coroner or medical examiner, at the request of the procurement organization, shall
attend the removal procedure for the part before making a final determination not to
allow the procurement organization to recover the part. During the removal procedure,
the coroner or medical examiner or designee of the coroner or medical examiner may

allow recovery by the procurement organization to proceed, or, if the coroner or
medical examiner or designee of the coroner or medical examiner reasonably believes
that the part may be involved in determining the decedent's cause or manner of death,
deny recovery by the procurement organization.
7. If the coroner or medical examiner or designee of the coroner or medical examiner
denies recovery under subsection 6, the coroner or medical examiner or designee of
the coroner or medical examiner shall:
a. Explain in a record the specific reasons for not allowing recovery of the part;
b. Include the specific reasons in the records of the coroner or medical examiner;
and
c. Provide a record with the specific reasons to the procurement organization.
8. If the coroner or medical examiner or designee of the coroner or medical examiner
allows recovery of a part under subsection 4, 5, or 6, the procurement organization,
upon request, shall cause the physician or technician who removes the part to provide
the coroner or medical examiner with a record describing the condition of the part, a
biopsy, a photograph, and any other information and observations that would assist in
the post-mortem examination.
9. If a coroner or medical examiner or designee of a coroner or medical examiner is
required to be present at a removal procedure under subsection 6, upon request the
procurement organization requesting the recovery of the part shall reimburse the
coroner or medical examiner or designee of the coroner or medical examiner for the
additional costs incurred in complying with subsection 6.
### § 23-06.6-23. Relation to Electronic Signatures in Global and National Commerce Act.

This chapter modifies, limits, and supersedes the federal Electronic Signatures in Global
and National Commerce Act [15 U.S.C. 7001 et seq.], but does not modify, limit, or supersede
section 101(a) of that Act [15 U.S.C. 7001], or authorize electronic delivery of any of the notices
described in section 103(b) of that Act [15 U.S.C. 7003(b)].
### § 23-06.6-24. Discrimination prohibited.

A person may not discriminate against a recipient at any point in the organ transplant
process, solely on the basis of the recipient's mental or physical disability, unless the disability
has been adequately determined to be medically significant to the provision of an anatomical
gift.
