4.4 Article

The Uniform Determination of Death Act is Being Revised

Journal

NEUROCRITICAL CARE
Volume 36, Issue 2, Pages 335-338

Publisher

HUMANA PRESS INC
DOI: 10.1007/s12028-021-01439-2

Keywords

Brain death; Ethics; Medicolegal

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The Uniform Determination of Death Act (UDDA), the recommended legal statute for determination of death in the United States, is being updated by the Uniform Law Commission (ULC) due to concerns raised by experts in various fields. The drafting committee is tasked with addressing key questions and proposing revisions to provide clarity and consistency in the distinction between life and death. Once finalized, individual states can choose to adopt the revisions.
The Uniform Determination of Death Act (UDDA), the recommended legal statute for determination of death in the United States, was initially formulated in 1981. Forty years later, because of the concerns of experts in medicine, law, ethics, and philosophy, the Uniform Law Commission (ULC) created a drafting committee to update the UDDA. The drafting committee, which has until 2023 to propose revisions to the ULC Executive Committee, will need to determine how to address the following key questions about the UDDA: (1) Should the term irreversible be replaced by the term permanent? (2) Is absence of hypothalamic-pituitary-axis-induced antidiuretic hormone secretion included in all functions of the entire brain, and if so, how can we reconcile the fact that this is not tested in the medical standards for determination of death by neurologic criteria published by the American Academy of Neurology and the Society of Critical Care Medicine, American Academy of Pediatrics, and Child Neurology Society? (3) What are the accepted medical standards for determination of death? (4) Is consent needed to determine death? and (5) How should objections to the use of neurologic criteria to declare death be handled? Once the ULC finalizes revisions to the UDDA, individual states will have the opportunity to decide whether to adopt the revisions in whole or in part. Hopefully, the revised UDDA will provide clarity and consistency about the legal distinction between life and death for physicians, lawyers, and the public at large. The events that led to the formation of the drafting committee and the potential consequences of revising the UDDA are discussed herein.

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