Analysis of statements in documents of gift for academic body donation programs in the United States, and recommendations for future practice

In US anatomical gift law, the record on which a person consents to body donation after death is referred to as a document of gift (DG). Due to the lack of legal requirements around minimum information standards, enacted recommendations in the United States, and the unknown variation across extant DGs, a review of publicly-available DGs from US academic body donation programs were performed to benchmark existing statements and recommend specific foundational content for all US DGs. From 117 body donor programs identified, 93 DGs were downloaded (median length three pages, range 1–20). Statements within the DG were qualitatively categorized into 60 codes within eight themes (Communication, Eligibility, Terms of Use, Logistics, Legal References, Financials, Final Disposition, and Signatures), using existing recommendations of academics, ethicists, and professional associations to guide analysis. Of 60 codes, 12 had high disclosure rates (67%–100% of DGs included; e.g., donor personal information), 22 had moderate rates (34%–66%; e.g., discretion to decline a body), and 26 had low disclosure rates (1%–33%; e.g., testing bodies for disease). Some codes with the lowest disclosure frequency were those previously recommended as necessary. Findings highlighted substantial variation in DG statements, with a higher number of baseline disclosure statements than previously recommended. These results present an opportunity to better understand disclosures that have importance for programs and donors alike. Recommendations suggest minimum standards of informed consent practices for body donation programs in the United States. These include clarity around consent processes, consistency of language, and minimum operational standards for informed consent.