Body Bequeathal Information and Bequeathal Forms

Transcription

1 Body Bequeathal Information and Bequeathal Forms Version Control Information: Last changed by: Peter Bazira Last changed date: :31: (Wed, 16 Mar 2011) Last changed revision: 118 Document filename: bequeathal.tex

2 Contents 1 General Information 2 2 Restrictions on Acceptance of Bequeathals 2 3 Procedure for Bequeathal 3 4 Procedure at time of death 3 5 Duration of Anatomical Examination Indefinite retention year restriction with retention of parts year restriction without retention of parts Use of Images 5 7 Final Procedure 5 8 Expenses 5 9 Withdrawal of Consent 5 10 Enquiries or Complaints 6 11 Further Information 6 12 Accessibility 6 Guidance notes for completing the Bequeathal Form 7 Bequeathal Forms 1

3 1 General Information The Hull York Medical School has a continuing requirement for human bodies for the purposes of Anatomical Examination, Education, Training and Research and is greatly indebted to the publicspirited individuals who bequeath their bodies for these purposes. Such bequeathal is regulated by the Human Tissue Act 2004 and overseen by the Human Tissue Authority. Bequeathing one s body is not the same as donating organs for transplantation. If you wish to donate organs for transplantation, you should carry a donor card, available from General Practitioners, some hospitals and chemists. If you carry a donor card, you can still bequeath your body for teaching and research. If, however, organs are removed for transplantation at the time of death, this may preclude acceptance of the bequeathal (see section 2 below). If you decide to bequeath your body, it is important that you discuss this with your next-of-kin and/or executor(s) so that they are aware of your wishes. You have the right to withdraw your bequeathal at any time, by contacting the Hull York Medical School at the address on the Bequeathal Form. 2 Restrictions on Acceptance of Bequeathals It is necessary to place the following restrictions on bequeathals: 1. Bequeathals are normally only accepted from those residing within approximately 50 miles of the Hull York Medical School. 2. Bequeathals are not normally accepted from individuals under the age of Bequeathals cannot normally be accepted from those who have pre-existing medical conditions that would make the body either unsafe for handling/embalming or unsuitable for anatomical examination. The following is a non-exhaustive list of such conditions: Gross peripheral oedema Severe obesity Transmissible diseases e.g. human transmissible spongiform encephalopathies (e.g. Creutzfeldt- Jakob Disease) or prion disease. We will only accept bequeathals with history of dementia on the condition that the dementia has lasted more than 2 years without: Family history of dementia History of myoclonus, visual or cerebellar problems, pyramidal/extrapyramidal signs or akinetic mutism Any other history suggestive of Creutzfeldt-Jakob or prion disease. We will follow prevailing Department of Health guidance which advises against embalming bodies known to carry anthrax, cholera, lassa fever, invasive group A streptococcal infection, plague, rabies, typhus, viral haemorrhagic fevers, yellow fever and viral hepatitis 2

4 The final acceptance of the body may be subject to the following additional restrictions: 4. We are unable to accept bodies that are subject to post-mortem examination, and/or under the Coroners jurisdiction. 5. If organs are removed for transplantation after death, we will not be able to accept the body, with the exception that bodies from which the eyes only have been removed may still be accepted. 6. The Hull York Medical School reserves the right to decline a bequeathal if, at the time of death, there is insufficient storage space, a shortage of staff, or for any other reason. 7. Even though your bequeathal has been registered with us, it may happen that, at the time of death the Hull York Medical School is unable to accept your bequeathal. In this circumstance your next-of-kin or executor(s) must make private arrangements for your cremation or burial at their expense. 3 Procedure for Bequeathal I Discuss your intentions with your next-of-kin and/or executor(s). II Complete both of the forms supplied with this leaflet, sign both copies in the presence of a witness, and have the witness sign both copies in your presence. III Return one Bequeathal Form to the address indicated. IV Retain this information pack and the second Bequeathal Form. These should be kept in a safe place that is known to your next-of-kin or executor(s) preferably with with your Will or legal papers. 4 Procedure at time of death The death must be certified and registered with the local Registrar of Births, Deaths and Marriages by your next-of-kin or executor(s). The Registrar will issue a Green Form and a Death Certificate (A small charge may be levied in some cases). This must be done before our Funeral Director can remove your body to the Hull York Medical School. The Mortuary Manager at the Hull York Medical School (Tel: ) should be notified as soon as possible, so that arrangements can be made promptly to remove the body to the anatomy facilities for preservation by embalming. The Hull York Medical School telephones are open from 9.00 am to 5.00 pm from Monday to Friday but closed on weekends and Bank Holidays. There is a voice mail system and relatives should leave their name and telephone number as a recorded message so that we can deal with it promptly. The offer of a bequest will be considered immediately the Medical School re-opens. During the major public holidays (Christmas, New Year and Easter) or during longer periods of closure the Hull York Medical School is unable to accept bodies. During these times, next-of-kin are advised to make private arrangements for a funeral at their own cost. 3

5 If the body lies in a hospital he/she should be held under refrigerated conditions in the hospital mortuary until the Hull York Medical School re-opens and can deal with the donation. The maximum time for holding is dependent on refrigeration. If the body is at home or at a nursing home it should be removed to a Chapel of Rest by an undertaker, and held under refrigerated conditions if possible. If no refrigeration is available the maximum time for such storage is about three days. 5 Duration of Anatomical Examination The Human Tissue Act 2004 does not place a limit on the length of time that a donated body can be used by the Hull York Medical School. In practice we tend to keep donated bodies and/or parts for about 3-5 years which is approximately how long they remain in usable condition. You may however wish to restrict the length of time we can use your body to 3 years. 5.1 Indefinite retention We hope you will consider consenting to the retention of your body or parts of it for an indefinite period. This would enable us to keep any parts of your body that may be of exceptional value for teaching, research and display of anatomical features for as long as they remain usable. If you consent to this (by ticking option 1 on the bequeathal forms], small unusable parts of your body and any waste tissue generated during the period of anatomical examination will be disposed of separately by incineration. Please note that it may not therefore be possible to cremate your entire remains at one go, or to provide your ashes to your next-of-kin year restriction with retention of parts If you wish to restrict the time that your body is used to a maximum of 3 years, and yet permit us to keep parts of it for longer, you may do so by ticking the corresponding box [ option 2 part (a) ] on the bequeathal form. Any small unusable parts of your body and any waste tissue generated during the period of anatomical examination will be stored and cremated together with the rest of your body within 3 years of your death. Any parts of your body deemed to be of exceptional value for teaching will be kept beyond the date of cremation of the rest of your remains year restriction without retention of parts If you wish to restrict the time that your body or its parts are used to a maximum of 3 years, you may do so by ticking the corresponding box [ option 2 part (b) ] on the bequeathal form. Any parts of your body and any waste tissue generated during the period of anatomical examination will be stored and cremated together with the rest of your body within 3 years of your death. 4

6 6 Use of Images It may be useful to prepare images (Still, Radiographic or Video) of parts of your body for teaching, training, and research or broadcast purposes. You are assured that, if you consent to this, you will not be identifiable in these images. If you do not wish to consent to the use of images you may indicate this on the bequeathal form. 7 Final Procedure When anatomical examination is complete, we will arrange for your remains to be cremated. Cremation will normally take place at Hull Crematorium. 8 Expenses No payment is made to the individual concerned or to relatives, but the Hull York Medical School pays all undertaking and cremation charges. No claim is made by the Hull York Medical School on any insurances payable at death and no attempt is made by the Hull York Medical School to recover its expenses from the Estate of the deceased or from relatives, unless special arrangements have been requested which require a departure from our usual procedures. Thus, for example, if your body has to be transported to a Chapel of Rest by an undertaker during periods of closure of the Hull York Medical School, the costs of such transport and the undertaker fees must be borne by your next-of-kin or executor(s). 9 Withdrawal of Consent If, at any time after completing the bequeathal process, you change your mind, you may withdraw your consent (i.e. cancel the bequeathal) by writing to Anatomy Bequeathals, Hull York Medical School, The University of Hull, Cottingham Road, Hull, HU6 7RX. Confirmation of receipt and a formal acknowledgement of your withdrawal of consent will be sent to you in writing. The taking and displaying of images (including photographs, films and electronic images) is outside the scope of the Human Tissue Act 2004; however, the HTA endorses the good practice principles set out in guidance issued by relevant professional and regulatory bodies. For further information, please refer to the HTAs Codes of Practice, available at 5

7 10 Enquiries or Complaints If you have a question or concern about any aspect of the bequeathal process, you may telephone, or write to: Anatomy Bequeathals, Hull York Medical School, The University of Hull, Cottingham Road, Hull, HU6 7RX Telephone contacts: Bequeathal Secretary Mortuary Manager Designated Individual / peter.bazira@hyms.ac.uk 11 Further Information Further information regarding bequeathal for Anatomical Examination can be found on the website of the Human Tissue Authority ( 12 Accessibility This document can be made available in large print or electronically upon request to the Anatomy Bequeathal Office. 6

8 GUIDANCE NOTES FOR COMPLETING THE BEQUEATHAL FORM Part A Complete the general details of your name, address, etc. Box ticking options: Tick option 1 if you do not place any restriction on the length of time that your body or body parts may be retained. If you choose this option, proceed to option 3 and leave option 2 boxes blank. Choose option 2 if you wish to place a restriction on the length of time that your body or body parts may be retained. If you choose this option, tick either (a) or (b) but not both. Option 3: Occasionally we may wish to use an image of your body or body parts. Tick this option if you agree to this. If you do not agree, leave the box blank. Option 4: If the Hull York Medical School is unable to accept your body at the time of death, it may be possible for another medical school to do so. Tick this option if you agree to this. If you do not agree, leave the box blank. Option 5 (Funeral arrangements): Please choose only ONE of the options. If you choose to have a medical school cremation and would like your ashes collected by a relative, give the name and address of the person who will collect the ashes. Signature of Donor: Please sign your name in the space for Signature of Donor and insert the date. Part B Witness Declaration After completing Part B, your witness should sign his/her name in the space for Signature of Witness and insert the date. In order to confirm that you have completed your form in the presence of a witness, the dates of your signature and your witnesss signature must be the same. Donor s Medical History Please complete the Donor s Medical History which is on the second page of the Bequeathal Form. The completed Bequeathal Form should be returned to: Anatomy Bequeathals Hull York Medical School The University of Hull Cottingham Road HULL HU6 7RX The second copy of the Bequeathal Form should be retained for your own records. 7

9 HULL YORK MEDICAL SCHOOL BEQUEATHAL FORM Please read the attached Information for Donors before completing this form Part A: to be completed by person making donation Please complete in BLOCK CAPITALS Title: Forename(s): Address: Postcode: Date of birth: Surname/family name: Tel no.: Religion/Faith group (if applicable): I WISH TO DONATE MY BODY AFTER MY DEATH. I UNDERSTAND THAT IT MAY BE USED FOR ANATOMICAL EXAMINATION, EDUCATION, TRAINING, RESEARCH AND PUBLIC DISPLAY. Please tick as appropriate: Pick either option 1 or 2 NOT both 1. I do not place any restrictions on the length of time that my body or body parts may be retained (if you tick this box, go straight to option 3, if not proceed to option 2). For option 2, please select either (a) or (b) then proceed to option My body can be retained for a maximum of 3 years only. (only tick this box if you haven t ticked option 1) (a) Parts of my body may be retained for longer than 3 years. OR (b) No part of my body may be kept for more than 3 years. 3. I consent to the use of images of my body or body parts. I understand that they will be used for anatomical examination, education, training, research or public display and that I will not be identifiable in these images. 4. I consent for this offer of bequeathal to be transferred to another Institution should the Hull York Medical School be unable to accept my body. 5. Funeral Arrangements (tick only ONE of the options below) Hull York Medical School cremation Private Funeral I wish to have a private funeral with all arrangements made by my next-of-kin and/or executor(s). I am fully aware that this means all funeral costs will be borne by my next-of-kin and/or executor(s). I wish to have my ashes: Scattered in the Garden of Rest at the Crematorium. OR Collected by a relative. Signature of donor: Date: Please complete Part B overleaf

10 Part B: Witness declaration (signature of next of kin, executor, GP, friend, etc.) I confirm that I have witnessed A of this form. Surname/family name: Forename(s): (insert name of donor) completing PART Address: Postcode: Signature: Relationship to donor: Date: Complete both forms. Return one form to: Anatomy Bequeathals, Hull York Medical School, The University of Hull, Cottingham Road, Hull, HU6 7RX and keep the other with your Will or legal papers. Donor s Medical History Tick the corresponding box if you have had either of the following medical devices fitted: Pacemaker Defibrillator Please provide a brief medical history below. Important disorders such as severe illnesses, infectious diseases, serious accidents or wounds, or major operations should be mentioned, but not common or minor illnesses. Give approximate dates and state if you were treated as an in-patient and the name of the hospital. Such information may give us leads to points of medical or surgical interest. Name and address of your Doctor: Data Protection: The Universities of Hull and York are data controllers and are registered with the Information Commissioners Office as required by the Data Protection Act The Universities require this information in order to maintain records of individuals bequeathing their bodies and will only process your data in accordance with the Universities notification and in line with data protection legislation. Information contained on this form will be disclosed to members of the Universities staff as is necessary. 9

11 HULL YORK MEDICAL SCHOOL BEQUEATHAL FORM Please read the attached Information for Donors before completing this form Part A: to be completed by person making donation Please complete in BLOCK CAPITALS Title: Forename(s): Address: Postcode: Date of birth: Surname/family name: Tel no.: Religion/Faith group (if applicable): I WISH TO DONATE MY BODY AFTER MY DEATH. I UNDERSTAND THAT IT MAY BE USED FOR ANATOMICAL EXAMINATION, EDUCATION, TRAINING, RESEARCH AND PUBLIC DISPLAY. Please tick as appropriate: Pick either option 1 or 2 NOT both 1. I do not place any restrictions on the length of time that my body or body parts may be retained (if you tick this box, go straight to option 3, if not proceed to option 2). For option 2, please select either (a) or (b) then proceed to option My body can be retained for a maximum of 3 years only. (only tick this box if you haven t ticked option 1) (a) Parts of my body may be retained for longer than 3 years. OR (b) No part of my body may be kept for more than 3 years. 3. I consent to the use of images of my body or body parts. I understand that they will be used for anatomical examination, education, training, research or public display and that I will not be identifiable in these images. 4. I consent for this offer of bequeathal to be transferred to another Institution should the Hull York Medical School be unable to accept my body. 5. Funeral Arrangements (tick only ONE of the options below) Hull York Medical School cremation Private Funeral I wish to have a private funeral with all arrangements made by my next-of-kin and/or executor(s). I am fully aware that this means all funeral costs will be borne by my next-of-kin and/or executor(s). I wish to have my ashes: Scattered in the Garden of Rest at the Crematorium. OR Collected by a relative. Signature of donor: Date: Please complete Part B overleaf

12 Part B: Witness declaration (signature of next of kin, executor, GP, friend, etc.) I confirm that I have witnessed A of this form. Surname/family name: Forename(s): (insert name of donor) completing PART Address: Postcode: Signature: Relationship to donor: Date: Complete both forms. Return one form to: Anatomy Bequeathals, Hull York Medical School, The University of Hull, Cottingham Road, Hull, HU6 7RX and keep the other with your Will or legal papers. Donor s Medical History Tick the corresponding box if you have had either of the following medical devices fitted: Pacemaker Defibrillator Please provide a brief medical history below. Important disorders such as severe illnesses, infectious diseases, serious accidents or wounds, or major operations should be mentioned, but not common or minor illnesses. Give approximate dates and state if you were treated as an in-patient and the name of the hospital. Such information may give us leads to points of medical or surgical interest. Name and address of your Doctor: Data Protection: The Universities of Hull and York are data controllers and are registered with the Information Commissioners Office as required by the Data Protection Act The Universities require this information in order to maintain records of individuals bequeathing their bodies and will only process your data in accordance with the Universities notification and in line with data protection legislation. Information contained on this form will be disclosed to members of the Universities staff as is necessary. 11