Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
SEVENTEENTH CONGRESS
Third Regular Session

8609

House Bill no.

Introduced by Representative Wes Gatchalian

EXPLANATORY NOTE

This bill creates a statutory presumption that when a person dies, he/she is
deemed to have consented to having his/her organs donated, UNLESS if he/she
during his/her lifetime made an express declaration of a contrary intention. This bi
shifts from the system where unless a person performs a positive act prior to hi
death, his organs may not be utilized for transplant. This bill admittedly
revolutionizes organ donation in the Philippines because precisely, the realities of
our context require nothing short of a revolution.

According to the numbers collated by the Department of Héalth (DOH) and by
the Philippine Network for Organ Sharing (PHILNOS), each year there are at least
twelve-thousand (12 000) new patients requiring kidney transplant. At present only
ten percent (10%) of those requiring transplant are able to avail of it primarily due
to the scarcity of available organs. In comparison to other countries in the west, who
themselves are plagued with continuing problems of organ scarcity, and whose
average donor per million runs between to 10-35, our country’s average is currently
ata measly 0.5 donor per million. These staggering numbers are but a translucent
window into a much dimmer reality where a number of our people would rather not
even opt for any medical service, knowledgeable of the fact that the costs they entail
are beyond their financial capacities. These people do not form part of our statisti
and yet their plights are equally our business. It is submitted that the effect of this
act, as was seen in other countries like Austria, France, Spain, Belgium, etc., that have
adopted the same measure, would be to create an increase in the supply of organs
ble, proportionately decreasing the barrier of cost and increasing the chance of
survival of those who require it. It is also submitted that a residual effect is to also
weaken the black market in organ selling as the necessity for it is dissipated by the
availability of legitimate avenues to receive organs.

Presuming the consent or the will of a deceased is without a doubt a crucial
policy consideration. Globally it is an accepted policy, and as established in the
preceding paragraph, has led strides towards solving the ills of organ scarcity.
Furthermore, contrary to the knee-jerk impulse of the reader, it is also not a new
concept in our country as we have the same policy in intestate succession whereby
by statute we presume the will of the decedent. Even more in our system of
legitimes, by statute we compel the disposition of a decedent his actual intent
notwithstanding. It is submitted that fundamentally the core policy of this bill
merely does the same.


‘As a final word, I concede that proposing this bill opens floodgates of
discussions that would thrust us into the very core of our understanding of what this
elusive term “human dignity” entails. This bill will force people into diametrically
opposing positions. And each of us will be forced to decide whether or not we
believe that giving a part of ourselves, when we no longer require them, is a duty we
have to our fellows. But lest | pre-empt these discussions, and lest | argue with
strawmen, it is for the current purposes sufficient to note my belief that it is in the
Filipino spirit and consciousness the he has this most noble animus of generosity. It
is who we are as a people that we derive pleasure, perhaps at times irrationally, to
give and to provide for others sometimes even to a fault. This bill is in the spirit of
“payanihan.” It is therefore not a stretch to presume that a person who dies would
beyond the grave want to be able to give to his community if he can

On. WES GATCRALIAN
Representative


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
SEVENTEENTH CONGRESS
‘Third Regular Session

8609

House Bill no.

Introduced by Representative Wes Gatchalian

AN ACT
AMENDING R.A. 7170, OR OTHERWISE KNOWN AS THE “ORGAN DONATION
ACT OF 1991, AND IMPLEMENTING A SYSTEM OF DEEMED CONSENT”

Be it enacted by the Senate and the House of Representatives of the
Philippines in Congress assembled:

SECTION 1. Short Title. - This Act shall be known as the "OPT-OUT ORGAN
TRANSPLANTATION ACT OF 2017"

Section 2. Declaration of Policy. - \t is hereby declared that the State shall
protect the right to health of the people. To achieve such objective, the State
among others, shall ensure that it can provide adequate supply of human organs
for transplantation to its people who are in need to prolonged their life and
become a better citizens in the future.

Section. 3. Definition of Terms. - As used in this Act the following terms shall
mean;

(a) "Organ Bank Storage Facility" - a facility licensed, accredited or approved
under the law for storage of human bodies or parts thereof.

(b) "Decedent’ - a deceased individual, and includes a still-born infant or fetus.
(c) "Testator” - an individual who makes a legacy of all or part of his body.

(d) "Donor" - an individual authorized under this Act to donate all or part of the
body of a decedent.

(e) “Opt-Out” - As provided in this act, “Opt-Out” shall mean to be as the positive
act of a person categorically registering themselves to the appropriate office as
indicated herein that he or she does not consent to subject his human organs,
remains and / or any parts of his body to be subject for transplantation to
another persons.

(f) ‘Deemed Consent” - Is the presumption of consent by the failure of a person to
register in the appropriate office of his desire not to subject his human organs,
remains and / or any parts of his body for transplantation to another persons.

(g) "Hospital" - a hospital licensed, accredited or approved under the law, and
includes, a hospital operated by the Government.

(h) "Part" - includes transplantable organs, tissues, eyes, bones, arteries, blood,
other fluids and other portions of the human body.



(i) "Person" - an individual, corporation, estate, trust, partnership, association,
the Government or any of its subdivisions, agencies or instrumentalities,
including government-owned or -controlled corporations; or any other legal
entity.

(i) "Physician" or "Surgeon" - a physician or surgeon licensed or authorized to
practice medicine under the laws of the Republic of the Philippines.

(k) "Immediate Family" of the decedent - the persons enumerated in Section 4(a)
of this Act.

(I) "Death" - the irreversible cessation of circulatory and respiratory functions or
the irreversible cessation of all functions of the entire brain, including the brain
stem. A person shall be medically and legally dead if either:

(1) In the opinion of the attending physician, based on the acceptable standards
of medical practice, there is an absence of natural respiratory and cardiac
functions and, attempts at resuscitation would not be successful in restoring
those functions. In this case, death shall be deemed to have occurred at the time
these functions ceased; or

(2) In the opinion of the consulting physician, concurred in by the attending
physician, that on the basis of acceptable standards of medical practice, there is
an irreversible cessation of all brain functions; and considering the absence of
such functions, further attempts at resuscitation or continued supportive
maintenance would not be successful in resorting such natural functions. In this
case, death shall be deemed to have occurred at the time when these conditions
first appeared.

‘The death of the person shall be determined in accordance with the acceptable
standards of medical practice and shall be diagnosed separately by the attending
physician and another consulting physician, both of whom must be appropriately
qualified and suitably experienced in the care of such parties. The death shall be
recorded in the patient's medical record.

Section 4. Transplantation Activities, When Lawful - ‘Transplantation
activities are lawful if done with express consent when one is required, or
otherwise with “deemed consent.”

Section 5. Transplantation Activities - The following shall be considered as
transplantation activities:

a, Storing the body of a deceased person for use for the purpose of
transplantation;

b. Removing from the body of a deceased person, for use for that
purpose, any relevant material of which the body consists or which it contains;

¢. Storing for use for that purpose any relevant material that has come
from the human body;

d. Using for that purpose any relevant material that has come from the
human body.


Provided, that a transplantation activity of the kind mentioned
in paragraphs (c) or (d) hereof is lawful (without the need for consent)
where done in Philippines if —

(a) The relevant material has been imported into the
Philippines, and

(b) Its removal from a person's body took place outside
the Philippines.

Section 6. Opt-Out; How Done - For purposes of this Act, any person desiring
not to have his body parts be subject of transplantation shall register his desire
to the same before the Barangay where he is a resident of. For this purpose the
barangay is mandated to forward this registration with the Department of
Health, Those who failed to register shall, at the time of their death, have deemed
to express their consent to subject their body parts for organ transplantation.

Section 7. Person Who May Execute A Legacy. - Any individual, at least
eighteen (18) years of age and of sound mind, may give by way of legacy, to take
effect after his death, all or part of his body for any purpose specified in Section 5
hereof.

Section 8. Person Who May Execute a Donation. - Pursuant to Sec. 11 hereof,
the decedent who have deemed to give their consent by means of a donation to
subject their body parts for organ transplantation, the following persons, in the
order stated hereunder, and in the absence of actual notice of contrary intentions
by the decedent shall have the right of choice to whom a particular organ shall be
given:

(1) Spouse;

(2) Son or daughter of legal age;

(3) Bither parent;

(4) Brother or sister of legal age; or

(5) Guardian over the person of the decedent at the time of his death

(b) The persons authorized by sub-section (a) of this Section may make the
donation afterdeath.

Section 9, Examination of Human Body or Part Thereof. - A legacy of all or
part of a human body authorizes any examination necessary to assure medical
acceptability of the legacy or donation for the purpose(s) intended.

For purposes of this Act, an autopsy shall be conducted on the cadaver of
accident, trauma, or other medico-legal cases immediately after the
pronouncement of death, to determine qualified and healthy human organs for
transplantation and/or in furtherance of medical science

Section 10. Persons Who May Become Legatees or Donees. - The following
persons may become legatees or donees of human bodies or parts thereof for
any of the purposes stated hereunder:

(a) Any hospital, physician or surgeon - For medical or dental education,


research, aavancement of meaicat or dentai science, therapy or transprantation
(b) Any accredited medical or dental school, college or university - For education,
research, advancement of medical or dental science, or therapy;

(c) Any organ bank storage facility - For medical or dental education, research,
therapy, or transplantation; and

(d) Any specified individual - For therapy or transplantation needed by him,

(e) The State in default of any of the preceding, and as defined by the succeeding
section.

Section 11. “Deemed Consent; treatment thereof. - Upon death of a person,
the medical attendant attending to the body of the deceased shall verify with the
Department of Health whether or not the said deceased have elected the “opt-
out” provisions of this act. If the deceased did not register, it shall be presumed
that he had given his “deemed consent” to subject his human organs, remains
and / or any parts of his body to be subject for transplantation to another
persons.

Section 12. Incentives, - Any person whose human organs, remains and / or any
parts of his / her body will be subjected for transplantation to another persons,
shall upon effectivity of this Act, receive incentives from the government, the
nature and specifics of the incentives shall be further laid down by the
Department of Health by means of an implementing rule.

Provided the deceased, during his lifetime, shall be entitled to the maximum
benefits provided by the PhilHealth if he registers to bequeath his organs to the
State within the period defined by Section 22 of this Act.

Provided further than in all cases, a person who consents, whether express or
implied, to donate his organs to the State, his estate shall be entitled to a ten
percent (10%) reduction of its tax duties.

Section 13. Duty of Hospitals. - A hospital authorized to receive organ
donations or to conduct transplantation shall train qualified personnel and their
staff to handle the task of introducing the organ donation program in a humane
and delicate manner to the relatives of the donor-decedent enumerated in
Section 4 hereof. The hospital shall accomplish the necessary form or document
as proof of compliance with the above requirement.

Section 14, Manner of Executing a Legacy. ~

(a) Legacy of all or part of the human body under Section 7 hereof may be made
by will. The legacy becomes effective upon the death of the testator without
waiting for probate of the will. If the will is not probated, or if it is declared
invalid for testamentary purposes, the legacy, to the extent that it was executed
in good faith, is nevertheless valid and effective.

(b) A legacy of all or part of the human body under Section 7 hereof may also be
made in any document other than a will. The legacy becomes effective upon
death of the testator and shall be respected by and binding upon his executor or
administrator, heirs, assigns, successors-in-interest and all members of the
family. The document, which may be a card or any paper designed to be carried
ona person, must be signed by the testator in the presence of two witnesses who
must sign the document in his presence. If the testator cannot sign, the document


may be signed for him at his discretion and in his presence, in the presence of
two witnesses who must, likewise, sign the document in the presence of the
testator. Delivery of the document of legacy during the testator's lifetime is not
necessary to make the legacy valid.
(c) The legacy may be made to a specified legatee or without specifying a legatee.
If the legacy is made to a specified legate who is not available at the time and
place of the testator's death, the attending physician or surgeon, in the absence
of any expressed indication that the testator desired otherwise, may accept the
legacy as legate. If the legacy does not specify a legatee, the legacy may be
accepted by the attending physician or surgeon as legate upon or following the
testator’s death. The physician who becomes a legatee under this subsection
shall not participate in the procedures for removing or transplanting a part or
parts of the body of the decedent.

(4) The testator may designate in his will, card or other document, the surgeon
or physician who will carry out the appropriate procedures. In the absence of a
designation, or if the designee is not available, the legatee or other persons
authorized to accept the legacy may authorize any surgeon or physician for the
purpose.

Section 15. Manner of Executing a Donation. - Any donation by a person
authorized under subsection (a) of Section 4 hereof shall be sufficient if it
complies with the formalities of a donation of a movable property.

In the absence of any of the persons specified under Section 4 hereof and in the
absence of any document of organ donation, the physician in charge of the
patient, the head of the hospital or a designated officer of the hospital who has
custody of the body of the deceased classified as accident, trauma, or other
medico-legal cases, may authorize in a public document the removal from such
body for the purpose of transplantation of the organ to the body of a living
person: Provided, That the physician, head of hospital or officer designated by
the hospital for this purpose has exerted reasonable efforts, within forty-eight
(48) hours, to locate the nearest relative listed in Section 4 hereof or guardian of
the decedent at the time of death.

In all donations, the death of a person from whose body an organ will be
removed after his death for the purpose of transplantation to a living person,
shall be diagnosed separately and certified by two (2) qualified physicians
neither of whom should be:

(a) A member of the team of medical practitioners who will effect the removal of
the organ from the body; nor

(b) The physician attending to the receipt of the organ to be removed; nor

() The head of hospital or the designated officer authorizing the removal of the
organ.

Section 16. Person(s) Authorized to Remove Transplantable Organs. - Only
authorized medical practitioners in a hospital shall remove and/or transplant
any organ which is authorized to be removed and/or transplanted pursuant to
Section 5 hereof.

Section 17. Delivery of Document of Legacy or Donation. - If the legacy or
donation is made to a specified legatee or donee, the will, card or other


document, or an executed copy thereof, may be delivered by the testator or
donor, or is authorized representative, to the legatee or donee to expedite the
appropriate procedures immediately after death. The will, card or other
document, or an executed copy thereof, may be deposited in any hospital or
organ bank storage facility that accepts it for safekeeping or for facilitation or
procedures after death. On the request of any interested party upon or after the
testator's death, the person in possession shall produce the document of legacy
or donation for verification.

Section 18. Amendment or Revocation of Legacy or Donation. ~

a) If he will, card or other document, or an executed copy thereof, has been
delivered to a specific legatee or donee, the testator or donor may amend or
revoke the legacy or donation either by:

(1) The execution and delivery to the legate or donee of a signed statement to
that effect; or

(2) An oral statement to that effect made in the presence of two other persons
and communicated to the legatee or donee; or

(3) A statement to that effect during a terminal illness or injury addressed to an
attending physician and communicated to the legatee or donee; or

(4) A signed card or document to that effect found on the person or effects of the
testator or donor.

(b) Any will, card or other document, or an executed copy thereof, which has not
been delivered to the legatee or donee may be revoked by the testator or donor
in the manner provided in subsection (a) of this Section or by destruction,
cancellation or mutilation of the document and all executed copies thereof.

Any legacy made by a will may also be amended or revoked in the manner
provided for amendment or revocation of wills, or as provided in subsection (a)
of this Section.

Section 19. Rights and Duties After Death. ~

(a) The legatee or donee may accept or reject the legacy or donation as the case
may be. If the legacy of donation is of a part of the body, the legatee or donee,
upon the death of the testator and prior to embalming, shall effect the removal of
the part, avoiding unnecessary mutilation. After removal of the part, custody of
the remainder of the body vests in the surviving spouse, next of kin or other
persons under obligation to dispose of the body of the decedent.

(b) Any person who acts in good faith in accordance with the terms of this Act
shall not be liable for damages in any civil action or subject to prosecution in any
criminal proceeding of this Act.

Section 20. International Sharing of Human Organs or Tissues. - Sharing of
human organs or tissues shall be made only through exchange programs duly
approved by the Department of Health: Provided, That foreign organ or tissue
bank storage facilities and similar establishments grant reciprocal rights to their
Philippine counterparts to draw organs or tissues at any time.

Section 21. Information Drive. - \n order that the public will obtain the
maximum benefits from this Act, the Department of Health, in cooperation with
institutions, such as the National Kidney Institute, civic and non-government


health organizations and other health related agencies, involved in the donation
and transplantation of human organs, shall undertake a public information
program.

The Secretary of Health shall endeavor to persuade all health professionals, both
government and private, to make an appeal for human organ donation.

Section 22. Implementation. The provisions of this law relating to "Deemed
Consent” as defined and provided for by Section 11, shall be applicable to a
deceased citizen of the Republic of the Philippines, five (5) years after the
effectivity of this Act.

Section 23. Rules and Regulations. - The Secretary of Health, after consultation
with all health professionals, both government and private, and non-government
health organizations shall promulgate such rules and regulations as may be
necessary or proper to implement this Act.

Section 24. Repealing Clause. - All laws, decrees, ordinances, rules and
regulations, executive or administrative orders, and other presidential issuance
inconsistent with this Act, are hereby repealed, amended or modified
accordingly.

Section 25. Separability Clause. - The provisions of this Act are hereby deemed
separable. If any provision hereof should be declared invalid or unconstitutional,
the remaining provisions shall remain in full force and effect.

Section 26. Effectivity. - This Act shall take effect after fifteen (15) days
following its publication in the Official Gazette or at least two (2) newspapers of
general circulation.

Approved.