It's Time to Revise the Uniform Determination of Death Act
Authors: Ariane Lewis, Richard J. Bonnie, Thaddeus Pope
Journal: Annals of Internal Medicine (2019)

Ideas and Opinions21 January 2020It's Time to Revise the Uniform Determination of Death ActAriane Lewis, MD, Richard J. Bonnie, LLB, and Thaddeus Pope, JD, PhDAriane Lewis, MDNYU Langone Medical Center, New York, New York (A.L.), Richard J. Bonnie, LLBUniversity of Virginia School of Law, University of Virginia School of Medicine, and Frank Batten School of Leadership and Public Policy, Charlottesville, Virginia (R.J.B.), and Thaddeus Pope, JD, PhDMitchell Hamline School of Law, Saint Paul, Minnesota (T.P.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2731 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In 1981, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research drafted the Uniform Determination of Death Act (UDDA). The goal was for all states to adopt it as the legal standard for death by neurologic criteria (DNC), thereby making the process for declaring death uniform around the country and providing legal support for declaration of DNC (1). The UDDA states, "An individual who has sustained either 1) irreversible cessation of circulatory and respiratory functions or 2) irreversible cessation of all functions of the entire brain, including the brainstem, is dead. A determination ...References1. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death. Washington, DC: US Gov Pr Office; 1981. Google Scholar2. Lewis A, Cahn-Fuller K, Caplan A. Shouldn't dead be dead? The search for a uniform definition of death. J Law Med Ethics. 2017;45:112-28. [PMID: 28661278] doi:10.1177/1073110517703105 CrossrefMedlineGoogle Scholar3. Siminoff LA, Burant C, Youngner SJ. Death and organ procurement: public beliefs and attitudes. Soc Sci Med. 2004;59:2325-34. [PMID: 15450707] doi:10.1016/j.socscimed.2004.03.029 CrossrefMedlineGoogle Scholar4. Lewis A, Adams N, Varelas P, et al. Organ support after death by neurologic criteria: results of a survey of US neurologists. Neurology. 2016;87:827-34. [PMID: 27449064] doi:10.1212/WNL.0000000000003008 CrossrefMedlineGoogle Scholar5. Winkfield v California, no. 4:15-06042 (N.D. Cal. 2015). Google Scholar6. In re Allen Callaway, no. DG-16-08 (Pondera County Dist. Ct., Mont. 2016). Google Scholar7. In re Mirranda Grace Lawson, no. CL16-2358 (City of Richmond Circuit Court, Va. 2016). Google Scholar8. In re Guardianship of Hailu, 361 P.3d 524 (Nev. 2015). Google Scholar9. Lewis A, Bernat JL, Blosser S, et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology. 2018;90:423-6. [PMID: 29386276] doi:10.1212/WNL.0000000000005033 CrossrefMedlineGoogle Scholar10. Nev. Rev. Stat. § 451.007 (2017). Google Scholar Author, Article, and Disclosure InformationAffiliations: NYU Langone Medical Center, New York, New York (A.L.)University of Virginia School of Law, University of Virginia School of Medicine, and Frank Batten School of Leadership and Public Policy, Charlottesville, Virginia (R.J.B.)Mitchell Hamline School of Law, Saint Paul, Minnesota (T.P.)Disclaimer: This paper summarizes a longer article on the authors' recommendations for revising the UDDA published in The Journal of Law, Medicine & Ethics in December 2019 entitled, "Determination of Death by Neurologic Criteria in the United States: The Case for Revising the Uniform Determination of Death Act." Although the AAN supports revising the UDDA to ensure a consistent legal approach to determination of DNC throughout the United States, the views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the AAN.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2731.Corresponding Author: Ariane Lewis, MD, Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, 530 First Avenue, HCC-5A, New York, NY 10016; e-mail, ariane.kansas.[email protected]com.Current Author Addresses: Dr. Lewis: Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, 530 First Avenue, HCC-5A, New York, NY 10016.Mr. Bonnie: University of Virginia, 580 Massie Road, Room WB 179D, Charlottesville, VA 22903.Dr. Pope: Mitchell Hamline School of Law, 875 Summit Avenue, Room 320, St. Paul, MN 55105.Author Contributions: Conception and design: A. Lewis, R.J. Bonnie.Drafting of the article: A. Lewis, R.J. Bonnie, T. Pope.Critical revision of the article for important intellectual content: A. Lewis, R.J. Bonnie, T. Pope.Final approval of the article: A. Lewis, R.J. Bonnie, T. Pope.This article was published at Annals.org on 24 December 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIt's Time to Revise the Uniform Determination of Death Act Ariane Lewis , Richard J. Bonnie , and Thaddeus Pope It's Time to Revise the Uniform Determination of Death Act Edward J. Kasarskis and Larry B. 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Kasarskis, MD, PhD and Larry B. Goldstein, MDBrain Death Testing: Time for National UniformityControversies in Brain Death Declaration: Legal and Ethical Implications in the ICU 21 January 2020Volume 172, Issue 2Page: 143-144KeywordsBrainBrainstemDisclosureForecastingHeartHypothalamusNeurologyNeurosurgeryPediatricsPituitary gland ePublished: 24 December 2019 Issue Published: 21 January 2020 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...