The Uniform Law Commission (ULC) has postponed indefinitely an effort to revise the Uniform Determination of Death Act (rUDDA) to give hospitals and doctors more leeway in declaring patients clinically dead.
“In consultation with ULC leadership, and based on feedback from the first reading and our efforts to date, we have decided to pause the rUDDA effort,” said Committee Chair Samuel Thumma, Committee Vice Chair Eric Weeks, and Committee Reporter Nita Farahany in an email to participants.
“The result of this pause is that, although we will continue to hope mid-level principles will become apparent, no further drafting committee meetings will be scheduled at this time.,” the group said. “We will continue to monitor developments in this area, and if we see promising signs of a possible path forward toward a widely enactable revised act, we can then reassess having the committee resume its work.”
The ULC, a nonprofit organization that drafts model legislation for legislatures, grappled with the issue at its annual meeting in July. Commissioners considered changing the word “irreversible” to “permanent” in determining the cessation of circulatory or respiratory functions and using the phrase “permanent coma, cessation of spontaneous respiratory functions, and loss of brainstem reflexes” in place of “all functions of the entire brain.”
Concerns About Publicity
“During the ULC meetings, ‘publicity’ was one of the reasons that kept coming up to explain the trouble they were having in coming to a consensus,” said Heidi Klessig, M.D., a retired anesthesiologist who works with respectforhumanlife.com(see related article, opposite page) and is author of the upcoming book The Brain Death Fallacy.
Several organizations, including National Right to Life and The Arc, filed statements opposing the change. A primary concern has been the growth in the organ procurement industry. Patients must be alive for hospitals to be able to harvest organs such as the heart or lungs.
The decision to leave the UDDA unchanged is welcome news to Julie Grimstad, vice president of the Healthcare Advocacy and Leadership Organization (HALO) and grandmother of a young man who recovered from a comatose condition after a car accident.
“Josh is now home with his family (mom, dad, and nine younger brothers and sisters), getting around in a power chair, communicating with eye-gaze technology, and going to neuro-physical rehab five days a week for six hours a day,” said Grimstad in an email to supporters. “He is gaining abilities and strength, even starting to speak again and he has not lost his sense of humor or his intellectual curiosity. When the accident happened, Josh was in his second year at Tarleton University in Stephenville, TX. He is hoping to be able to return to school one day!”
Education Mission
Grimstad says there is pressure to loosen the definition of death.
“I can guarantee that this is not the end of efforts to make the legal criteria for determination of death less rigorous,” Grimstad told Health Care News. “Furthermore, those of us who believe every life is worth living must work tirelessly to educate the public that ‘brain death’ is not biological death, that such a diagnosis does not guarantee the person will not recover to a greater or lesser degree and cherish his or her life.”
Grimstad said her organization advocates repealing the current UDDA and replacing it with new language recommended by Paul A. Byrne, M.D., a board-certified pediatrician and neonatologist and the founder and president of the Life Guardian Foundation.
The proposed definition reads, “No one shall be declared dead unless respiratory and circulatory systems and the entire brain have been destroyed. Such destruction shall be in accord with universally accepted medical standards.”
AnneMarie Schieber (amschieber@heartland.org) is the managing editor of Health Care News.
For related articles on brain death, medical ethics, and organ transplants, click here.
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