Hospital Laws and Rules

(Sykehusloven av … Lov om helsepersonell av …)

Always remember the promise of Confidentiality that you have signed!

Remember that this also applies to the patient’s relatives. Even if you receive information from friends and relatives, you can not give them medical information back about the patient/deceased. The superior court has decided (H?yesterettsdom) that Norwegian patients have the right to see their own medical records. This means that only the patient or an authorized person (by the patient) can read the medical record. The doctor should be there during the reading of the record. The medical record can not be removed from the department as it is the property of the hospital. Copies can be made though. The head of each department gives the guidelines for the method in which the reading of a journal is to be handled. If a patient asks to read his/her medical record you should refer them to the doctor who is responsible for his/her treatment.

Death Criteria

A person is dead according to Norwegian law when there are definitive signs of total damage of the brain with a complete and irreversible absence of all cerebral, cerebellar and brain stem functions.

Permanent absence of spontaneous breathing and heartbeat are signs of total damage of the brain.

All the following criteria must be found to diagnose a person dead:

1. Established disease, process or injury intracranial

2. Total unconsciousness

3. Permanent absence of spontaneous breathing

4. Permanent absence of cranial nerve reflexes

5. Permanent absence of electrical activity in the brain (isoelectric or a “flat” line in the EEG)

6. Permanent absence of blood circulation to the brain, diagnosed by cerebral angiography (radiological examination of the blood vessels after the injection of a contrast medium)

Chapter I. Transplantation

§1

Organs or biological material can be used for the treatment of a disease or injury in another person if the donor has given written consent. Surgery can only be done if it does not endanger the donor. Consent can only be given by persons 18 years and above. In certain circumstances minors (under 18 years) can also give consent if it is approved by their parent(s) or legal guardian. If this is the case, the approval for the surgery must be obtained from Helsedirektoratet. Before consent can be given, a doctor must give the donor or all important information concerning the surgery and possible consequences. The doctor is obligated to make sure that the persons concerned, the donor, has understood the information and its implications.

§2

Organs and/or other biological material can be taken for the treatment of disease or injury of another person if the diseased has given written or oral consent. Even if this consent has not been given, surgery can be done on a patient that dies in the hospital or arrives dead after transportation, unless the diseased or his/her relatives have expressed that they are explicitly against it, or if there is reason to believe that the surgery would be against the patients or relatives religion and/or ethics or if there are other important contraindications. If possible, the relatives should be informed about the death before the surgery takes place.

§3

Surgery as mentioned in §2 must not be done when question of a forensic autopsy could arise and the surgery could influence or destroy this autopsy result.

§4

Before the surgery mentioned in §2 can be done, the death must be confirmed by two doctors that are not performing the surgery/transplantation. The surgery must be registered according to protocol. The protocol must include the following information: time and cause of death, names of the doctors that stated the death and which examination procedures were used. The surgery can not be performed by the doctor that treated the patient prior to death.

§5

Surgery after §1 and 2 is only allowed at hospitals approved by the Norwegian king.

§6

Blood collection, removal of small skin pieces and other minor surgical procedures equal to this can be done without involving these regulations (Hospital Laws and Rules).

Chapter II. Hospital Autopsies

§7

For medical reasons autopsies can be done on those who have died at the hospital or other health oriented institutions as cited in Sykehusloven of the 19th of June, 1969 nr. 57 § 1 first paragraph, or on those who are brought in deceased to this type of institution. An autopsy can not be done if the deceased or her/his immediate family will not permit it. An autopsy can not be done if the deceased or his/her relatives have expressed that they are against it, or if there is reason to believe that this kind of surgery would be against the patients or relatives religion and/or ethics or if there are other important contraindications. An autopsy can not be done before the immediate family has been notified of the death, and eight hours have elapsed from the time of death. The autopsy can be done sooner if there is consent from the deceased or her/his immediate family. If there are justifiable reasons to find the cause of death without any delay, an autopsy can be done regardless of these terms.

§8

Autopsy after §7 can not be performed if there is reason to believe that a forensic autopsy will be requested.

Published Nov. 23, 2005 5:00 PM