Journal
NEUROCRITICAL CARE
Volume 37, Issue 2, Pages 377-385Publisher
HUMANA PRESS INC
DOI: 10.1007/s12028-022-01567-3
Keywords
Brain death; Ethics; Medicolegal; Religion; Accommodation; Uniform Determination of Death Act
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This article provides a historical background and survey results related to the revision of the Uniform Determination of Death Act (UDDA) and explores the ethical principles and existing guidance regarding objections to the use of neurologic criteria to declare death. It also examines the perspectives of stakeholders and identifies questions for the drafting committee to consider, as well as the potential downstream effects of their decision.
In response to concerns about the declaration of death by neurologic criteria, the Uniform Law Commission created a drafting committee to update the Uniform Determination of Death Act (UDDA) in the Fall of 2021. One of the key questions for the committee to address was the following: Should the revised UDDA address objections to the use of neurologic criteria to declare death? This article (1) provides historical background and survey results that demonstrate the need to address this question; (2) summarizes the ethical principles that support and oppose accommodation of objections to the use of neurologic criteria to declare death; (3) reviews accommodation in other areas of medicine and law; (4) discusses existing legal and hospital guidance on management of these objections; (5) examines perspectives of stakeholder medical societies and expert health care professionals, lawyers, ethicists, and philosophers on whether the revised UDDA should address these objections; (6) identifies some questions for the drafting committee to consider when deciding whether the revised UDDA should address objections to the use of neurologic criteria to declare death; and (7) summarizes the potential downstream effects of the drafting committee's decision.
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