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Hospital Circular 9 /2005

Date Issued: 23 May 2005

Distribution: Public and private hospitals

Subject: Designated Officers of Hospitals

Hospitals are reminded of their responsibilities under the Human Tissue Act 1982 in relation to a designated officer.

Designated officers for hospitals play a vital role in the supervision of human tissue removal for transplantation, therapeutic, medical or scientific purposes. Under the Human Tissue Act, it is the role of designated officers to facilitate and scrutinize the removal of tissue from both living and deceased patients in the hospital. Importantly, because a designated officer is not employed by a tissue bank, and is not involved in the actual removal process, they are more likely to be viewed by the community as independent. Community confidence in the integrity of the tissue removal process is an important end in itself. Compliance with these processes underpins community support for the donation of organs and human tissue for transplant purposes.

The Human Tissue Act furnishes designated officers with broad powers and specifies a number of functions in relation to the removal of tissue. These powers and functions vary depending on whether the tissue is donated by a living person or after death. The Human Tissue Act makes it an offence to remove tissue from the body of a person other than in accordance with an authority granted under the Act.

Where a living person donates tissue, section 18 provides that a patient in a hospital who has given his or her consent in writing to the removal of tissue, may revoke that consent (orally or in writing) by indicating to a designated officer, a registered medical practitioner who is attending the donor in a professional capacity or a nurse employed at that hospital, that the consent is revoked. In such a case, the designated officer must inform the medical practitioner who is proposing to rely on the consent that the person’s consent has been revoked. This ensures that the tissue cannot be removed.

Section 19 sets out a similar provision in relation to a child who is a patient of a hospital and is no longer in agreement with the proposed removal of tissue.

A designated officer also has extensive powers in relation to the donation of tissue after a person has died. Section 26 provides that a designated officer for a hospital may authorize the removal of tissue from the body of a deceased person who has been a patient in the hospital, or has been brought into the hospital, for the purpose of transplantation of the tissue into the body of a living person, or for use in other therapeutic, medical or scientific purposes. This would occur for example, where a deceased person or their senior available next-of-kin has consented to such a donation.

Designated officers also have a role in authorising post-mortem examinations (under Part V) and in relation to the use of a deceased person’s body for study purposes and for teaching of the anatomy of the human body (under Part VI).

It is important that hospitals ensure that a person exercising these authorities is a designated officer within the meaning of the Human Tissue Act. This is set out in sections 3 and 4 of the Human Tissue Act. Hospitals should also note that they can appoint more than one designated officer at a time to ensure that there will always be a designated officer available when required.

Hospitals are requested to ascertain who currently exercises these authorities and review whether their designated officer appointments are sufficient.

Procedure for appointing a designated officer

Section 3-

A designated officer for a hospital must be either:

1. a registered medical practitioner for the time being appointed under section 4 to be a designated officer for that hospital; or
2. where, there is no such person, the medical superintendent of the hospital or, while he/she is absent from or not on duty at the hospital, a person acting in their place;

Section 4 provides that a registered medical practitioner must be appointed by instrument in writing by the person or persons or body having the control and management of a hospital.

Education programs for designated officer

Hospitals should ensure that designated officers are aware of their responsibilities under the Human Tissue Act. LIFEGift, the Victorian Organ Donation Service managed by the Australian Red Cross Blood Service, provides education programs for health professionals. If your hospital is regularly involved in the organ and tissue donation process and you believe that designated officers may benefit from access to a suitable education program, please contact Ms Dana Stojakovic [phone 03 9349 4762 or e-mail dstojakovic@arcbs.redcross.org.au to arrange for LifeGift to visit your institution to discuss the practical implications of this important role.

Register of Designated Officers

LIFEGift is currently compiling a register of designated officers for hospitals and will update this register annually. This will enable both LIFEGift and other donor tissue banks to promptly make contact with appropriate person/s in hospitals where necessary. Hospitals are requested to facilitate this process by contacting Dr Neil Boyce at LIFEGift (nboyce@arcbs.redcross.org.au or facsimile - 03 9349 2730) and provide details of their current designated officers.

Shane Solomon
Executive Director
Metropolitan Health and Aged Care Services