A non-profit organization that drafts model legislation for state legislatures met to change the definition of clinical death.
During its annual meeting in Honolulu, Hawaii, in July, the Uniform Law Commission (ULC) discussed a revision of the (UDDA). The group was unable to reach a consensus and the discussion will continue at a later date.
Dead or Alive?
Commissioners considered two options.
The first option was to keep the current definition, which states an individual is clinically dead if there is an irreversible cessation of circulatory and respiratory functions, or an irreversible cessation of all functions of the entire brain, including the brain stem.
The second option would change the word “irreversible” to “permanent,” and instead of “all functions of the entire brain,” would state “permanent coma, cessation of spontaneous respiratory functions, and loss of brainstem reflexes.”
“During the meeting, Professor Nita Farahany described the RUDDA (revised UDDA) language change this way: ‘irreversible’ means ‘cannot be reversed’; ‘permanent’ means ‘will not be reversed,’” wrote Klessig. “In short, this means that you can be declared legally dead because your doctors are unwilling to intervene on your behalf. This would allow the same person, with the same brain function, to be declared either dead or alive based entirely on their doctors’ intentions.”
Before the meeting, several dozen individuals and organizations, including the Association of American Physicians and Surgeons, the Catholic Medical Association, the Christian Medical and Dental Association, National Right to Life, and The Arc, objected to the revised definition.
The National Catholic Bioethics Center and the U.S. Conference of Catholic Bishops expressed their opposition in a joint statement.
“Nothing in Catholic teaching provides support for lowering the criterion to something less than ‘irreversible cessation of all functions of the entire brain,’” stated the Catholic groups. “We are opposed to lowering that standard in the absence of compelling scientific evidence.”
The statement also referenced a controversial new procedure that maintains oxygenation and blood flow to harvestable organs while shutting off blood flow to, and effectively killing, the brain.
“Under this controversial protocol, the transplant team could directly cause the death of the donor,” the organizations stated.
Legal Cover for Diagnosis
The push to change the death definition was prompted by a group of specialists, Klessig told Health Care News, on February 24.
“According to the American Academy of Neurology, the reason that these revisions are being proposed in the first place is to make it more difficult to challenge a brain death diagnosis in a court of law,” said Kessig. “Clearly, the revisions to the UDDA will stack the deck against families and will only promote the interests of the transplant industry.”
Canada Broadened Definition
The Euthanasia Prevention Coalition (EPC), a Canadian-based organization, notes that under the current standard, 50 to 84 percent of brain deaths are misdiagnosed.
“Remember Damar Hamlin, the football player who collapsed during a game when his heart stopped?” wrote Sara Buscher on the EPC blog, on June 19. “His heart was restarted several times on the field, but he was unconscious (i.e., in a coma) and ended up in the hospital on a ventilator.”
Buscher writes Hamlin could have been declared brain dead under the revised definition.
“What if the doctors decided to stop restarting his heart?”
Damar was treated, recovered, and is expected to play football again.
What Is Next?
“In a sense, the future is already here,” Klessig told Health Care News, prior to the July meeting.
“The proposal before the ULC is about changing the legal definition of death in America to reflect what doctors are already doing. … diagnosing death by neurological criteria according to looser standards than what the law stipulates,” said Klessig. “And this has led to lawsuits because families have recognized that doctors did not fulfill the requirements of current law when diagnosing their children or family members as brain dead.”
The new definition unacceptably defines as dead many who are alive, said Alex Schadenberg, international chair of EPC.
“The organ harvesting industry wants greater access to healthy organs,” said Schadenberg. “When a person is not dead yet, their organs are healthier because they have not experienced the deterioration that occurs soon after death ensues.”
‘Who Is Next?’
The revisions to the definition of death represent an incremental step toward more broadly defining death in a manner that marginalizes the cognitively disabled, says Schadenberg.
“All of these changes happen in steps,” said Schadenberg. “Now they are pushing to declare people who have significant cognitive injuries or disabilities as being dead. Soon they will define those with permanent, but less severe, cognitive disabilities as being dead. The question is, who is next?”
Nancy Valko, R.N., spokesperson for the National Association of Prolife Nurses, says the redefinition represents a risky move toward euthanasia and limiting informed consent.
“Another potential problem is ‘presumed consent,’ which is the assumption that everyone is willing to donate his/her organs unless there is evidence that they would not want to donate,” said Valko.
“Illinois narrowly avoided a ‘presumed consent’ statute a few years ago where people who didn’t want to donate had to file an opt-out document with the Secretary of State,” said Valko. “Even more horrifying, there have also been proposals to link organ donation and assisted suicide as a potential solution to the organ scarcity problem. Countries like Belgium and the Netherlands already allow this.”
Kevin Stone (email@example.com) writes from Arlington, Texas.
Canada Updates Death Determination Standards. Is America Next – Commentary, July 24, 2023, Heidi Klessig, M.D.
If You’re Incapacitated, Will the Hospital Save You? (Guest Heidi Klessig, M.D.) – Heartland Daily Podcast, July 31, 2023