Medical technologies, such as ventilators and feeding tubes, can help keep people alive who otherwise wouldn't survive. This may seem like a good thing to some, but not necessarily to everyone. Modern medicine has begun to blur the line between life and death, as certain life functions can be maintained even in the absence of brain activity. The Uniform Determination of Death Act (UDDA) is a piece of model legislation (non-binding statutory text meant to serve as a guide for state lawmakers), adopted nationwide, that provides a more concrete definition of death for legal purposes.
This article covers the basics of the UDDA, its legal significance, and examples of specific state laws addressing the criteria for declaring an individual's death. See Brain Death vs. Persistent Vegetative State: What is the Legal Difference? to learn more.
The Uniform Declaration of Death Act was drafted in 1981 by a President's Commission study on brain death. It was approved by both the American Medical Association (AMA) and the American Bar Association (ABA) shortly after its publication. Health care is handled on a state-by-state basis, so the intent of the Act was to provide a model for states to emulate.
The UDDA offers two definitions for when an individual may legally be declared dead:
Irreversible cessation of circulatory and respiratory functions; or
Irreversible cessation of all functions of the entire brain, including the brain stem.
The most common type of death is the first one, in which the heart has stopped beating and/or the patient is no longer breathing (usually followed by brain death). But sometimes (as in the second definition), an individual may be kept "alive" through the use of ventilators and feeding tubes even though there is zero brain activity. Most states consider brain dead individuals legally dead and remove them from life support, although the body's other life functions may be maintained until organs are harvested for donation.
Legal Significance of UDDA
The main purpose of the Act is to align the legal definition of death with the criteria largely accepted by the medical community. Since modern technology has allowed for the direct monitoring of brain activity, as well as the ability to maintain breathing and circulation in otherwise fatal conditions, the traditional definition of death needed to be expanded.
The definitions of death outlined in UDDA are relevant in many different legal situations across various legal practice areas. For example:
Organ Donation: A summary of the organ donation process by the Dept. of Health & Human Services explains the importance of maintaining organs and tissues for donation. The declaration of brain death is final and can help streamline the process by eliminating any ambiguity.
Criminal Cases: The law requires a legal declaration of death before prosecutors may charge a defendant with homicide.
Tort Actions: The declaration of death is necessary for a wrongful death lawsuit or other survivors' legal actions.
Estate Law: Without an official declaration of death, benefactors may not inherit an individual's estate.
Life Insurance: Since a brain dead individual cannot provide for his or her family, the finality of a death determination allows the disbursement of life insurance funds.
Declaration of Death: State Laws
Although all states (and the District of Columbia) have adopted the Uniform Declaration of Death Act -- most using the exact wording of UDDA -- some state laws add additional regulations. Some examples include:
Florida: Determination of death must be made by two doctors -- one the treating physician and the other a board-eligible neurologist, neurosurgeon, internist, pediatrician, surgeon, or anesthesiologist.
Texas: Except in situations where a patient is on life support, the determination of death (including brain death) may be made by a registered nurse or physician's assistant if the hospital's written policy allows.
Oregon: In the event of fetal death, "heartbeats shall be distinguished from transient cardiac contractions and breathing shall be distinguished from fleeting respiratory efforts or gasps."
Consider speaking with a health care attorney in your area if you have additional questions about UDDA or need legal advice.