The Christian Medical and Dental Association’s Letter to the Uniform Law Commission
15 February 2023
Re: Potential revision of the Uniform Determination of Death Act (UDDA)
For decades, the Uniform Determination of Death Act has served as the guiding clinical framework for establishing that an individual has died. In addition to the determination of death by the irreversible cessation of circulatory and respiratory functions, the statute affirms that death can be established by neurologic criteria.
Current guidelines hold that, in the face of a devastating and irreversible brain injury, death by neurologic criteria may be diagnosed when there is loss of all functions of the entire brain, including the brainstem, as manifested by irreversible coma, absent brainstem reflexes, and apnea. Since its inception more than fifty years ago, however, the UDDA has lacked the evidence-based scientific foundations that normally are requisite for clinical guidelines. The American Academy of Neurology (AAN) itself, which has published and promulgated these guidelines, acknowledges severe limitations in the current evidence base.