Bill 360.

Summary.

The bill proposes a nationwide framework for the people, facilities, and institutions involved in the donation, recovery, evaluation, processing, preservation, storage, distribution, and implantation of anatomical components. It defines types of donors and donations, informed consent, the legal presumption of donation, traceability, and transplantation procedures. The National Transplant Laboratory (Laboratorio Nacional de Trasplantes) would conduct histocompatibility studies. Brain death would be determined through 2 separate evaluations by physicians independent of the recovery or transplant team; the second evaluation would establish the time of death.

Organs from deceased donors would be offered first to Panamanian nationals on the National Waiting List (Lista de Espera Nacional) and, if there are none, to registered foreign residents. The Ministry of Health (Ministerio de Salud) would authorize the import and export of organs and tissues through recognized exchange organizations, subject to health controls and checks on recipient availability. Consent from the deceased donor’s relatives would follow an order of kinship and a 6-hour time limit. Trafficking in anatomical components and transplant tourism would be prohibited and subject to penalties under existing law.

Public institutions would cover costs under agreements between the Ministry of Health and the Social Security Fund (Caja de Seguro Social), without passing expenses on to living donors or the deceased donor’s family; costs at private centers would be agreed under the proposed rules. An insured donor would receive leave at full pay for the recovery period prescribed by their physician and protection against dismissal for donating. Living donors would receive medical follow-up. Both institutions would arrange free, ongoing access to immunosuppressants for transplant recipients. Recovery of organs and tissues from deceased donors would be treated as a medical emergency, and a donation recorded in the National Donor Registry (Registro Nacional de Donantes) would qualify for exemption from certain expenses and prompt release of the body.

Organ and tissue recovery and transplantation would be governed by the principles of free donation, voluntariness, altruism, and bioethics, including those of the World Health Organization (Organización Mundial de la Salud). Hospitals would keep donor and recipient information confidential. Ongoing promotional campaigns would be organized, with an allocation of at least 15% of the Panamanian Institute for Donation and Transplantation’s budget, and advertising donations for private benefit would be prohibited.

The bill would elevate the Panamanian Transplant Organization (Organización Panameña de Trasplantes) to the Panamanian Institute for Donation and Transplantation, known as IPADOT, with legal personality and financial and technical autonomy, under the direction of the Executive Branch (Órgano Ejecutivo) through the Ministry of Health and the oversight of the Office of the Comptroller General of the Republic (Contraloría General de la República). The Institute would coordinate programs, transport, and distribution; maintain waiting lists and donor and transplant registries; and receive activity reports during the first 5 days of each month. The bill would provide for budgetary resources, a Board of Directors, a director and deputy director selected through a competitive process for 6-year terms, and an Advisory Council of Patient and Family Organizations (Consejo Asesor de las Organizaciones de Pacientes y Familiares). The National Transplant Committee (Comité Nacional de Trasplantes) would advise and participate in professional certification; hospital committees would oversee each center’s programs.

Donation after death could be documented through a sworn declaration, authenticated document, card, identity card, or driver’s license, and revoked before the Institute; a person’s wishes expressed during life would prevail over objections from relatives. Organ allocation would take urgency, histocompatibility, and clinical criteria into account; tissues and cells held in banks would be allocated on a physician’s request. Living donors would have to meet requirements concerning legal capacity, information and written consent, psychiatric evaluation, kinship, and safety, with rules for minors, people deprived of liberty, and paired or altruistic donation. Recovery from deceased donors would require a diagnosis and certification of death, consent or a legal presumption of donation; cases involving forensic investigation and unidentified donors would involve the competent authority and the Criminalistics Department (Departamento de Criminalística). Tissue recovery in authorized morgues would be subject to controls by the Institute of Legal Medicine and Forensic Sciences (Instituto de Medicina Legal y Ciencias Forenses).

The title on hematopoietic cells and tissues would regulate their collection, transport, traceability, and processing in banks. It would require informed consent, documented procedures, and data protection; it would allow specified exceptions for minors and people unable to consent through their legal representatives. Donation would be free of charge, although certain private institutions could cover a living donor’s expenses and lost income. These provisions would concern hospitals, tissue banks, health professionals, patients, families, and transplant organizations, as well as public bodies responsible for health, social security, and forensic medicine.