The American College of Physicians (ACP) has issued a new paper addressing current controversies about the standards for determining death, supporting a clarification to the Uniform Determination of Death Act (UDDA) but otherwise reaffirming the current UDDA and the ethical principles that are its foundation. The paper is published in Annals of Internal Medicine.
is declared, sparking re-examination of the UDDA. The Uniform Law Commission appointed a committee that has been debating whether to revise the 1981 UDDA, the legal standard in the United States.
Competing revisions have been proposed, including everything from eliminating brain death altogether to stipulating that brain death means only the loss of certain specified functions. Also of concern is the extent to which issues ofand organ availability seem to be influencing efforts to modify the UDDA. While revisiting the more than 40-year-old UDDA is clearly indicated, ACP urges caution—and recommends that only a clarification revision is needed.
The paper also includes a glossary of important concepts and their definitions to further clarify these complex issues.
Revising the Uniform Determination of Death Act to replace the word"irreversible" with"permanent" in clarifying the permanent cessation of circulatory and respiratory functions, but retaining the word irreversible in describing brain death . Maintaining circulatory and whole brain standards for determining death as separate, independent standards, consistent with current medical practice and with respect for established standards as well as for those cultures andRetaining the whole brain standard for determining death according to neurologic criteria and opposing"higher
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