After surveying the views expressed by 41 advocacy, medical, and transplant-focused organizations on the Uniform Determination of Death Act, a brain injury expert is calling for much-needed reforms to the legal definition of death in the United States. The recently announced pause by the Uniform Law Commission, which is spearheading revisions, is disappointing, the expert notes, but should not permanently stall practical fixes to longstanding problems with the Death Act.
Specifically, Lewis argues, the legal description for death needs to reflect medical guidelines, which do not require that loss of hormone function be considered when declaring someone brain dead. Moreover, Lewis says, the Death Act needs to be revised to include legal guidance for healthcare providers about what to do when a family objects to stopping mechanically assisted breathing for a relative who is already brain dead.
The act, however, failed to specify the medical tests needed to determine if someone was dead. Furthermore, a small number of states allow families to voice objections on religious grounds. This includes some Orthodox Jews, Muslims, and Catholics who equate withdrawal of mechanical ventilation to euthanasia, even after a person has been declared brain dead.
The Death Act’s definition, Lewis argues, is not only too broad, but it is also impractical because there is currently no medically established standard for measuring whether and when hormone secretion from the brain has stopped. Thus, she says, the act should be clarified to specify what brain functions must be lost in order to declare someone legally dead, recognizing that loss of hormone secretion should not be among the criteria.