LIFEalerts – Medical Ethics

Medical Ethics

USA – New movement calls for a change in determining brain death

The Uniform Determination of Death Act (UDDA) is a model state law agreed upon in 1981 by a number of expert bodies, which gives criteria for deciding whether a severely brain-damaged person is dead or not. Most states have adopted it, but only two-thirds of them have used the complete language of the act. Now, a movement calling for revision of UDDA is a try for uniformity, and called the Revised Uniform Determination of Death Act (RUDDA). 107 experts in medicine, bioethics, philosophy, and law, spanning a wide variety of perspectives, agree that UDDA needs an update but not as RUDDA because: “ (1) the Guidelines have a non-negligible risk of false-positive error, (2) hypothalamic function is more relevant to the organism as a whole than any brainstem reflex, and (3) the apnea test carries a risk of precipitating BD [brain death] in a non-BD patient, provides no benefit to the patient, does not reliably accomplish its intended purpose, and is not even absolutely necessary for diagnosing BD according to the internal logic of the Guidelines; it should at the very least require informed consent, as do many procedures that are much more beneficial and less risky. The issue of brain death is as much metaphysics as medicine. It requires a deep understanding of both to define the necessary criteria. More