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Inconsistency between the Circulatory and the Brain Criteria of Death in the Uniform Determination of Death Act
Alberto Molina-Pérez1, James L Bernat2, Anne Dalle Ave3
1Instituto de Estudios Sociales Avanzados (IESA), CSIC, Córdoba, Spain.
Insights
The Uniform Determination of Death Act has two conflicting interpretations of "cessation of functions," leading to conceptual inconsistencies in determining death. This legal ambiguity impacts definitions of life and death, particularly with artificial life support.
Area of Science:
- Medical Law
- Bioethics
- Neuroscience
Background:
- The Uniform Determination of Death Act (UDDA) defines death based on irreversible cessation of circulatory, respiratory, or all brain functions.
- Current legal and medical practices rely on the UDDA for death determination.
- The UDDA's interpretation of 'cessation of functions' is subject to ambiguity.
Purpose of the Study:
- To analyze the conceptual inconsistencies within the Uniform Determination of Death Act (UDDA).
- To examine the conflicting interpretations of 'cessation of functions' in the UDDA.
- To explore potential solutions for resolving these inconsistencies in death determination.
Main Methods:
- Legal textual analysis of the Uniform Determination of Death Act (UDDA).
- Conceptual analysis of the phrase 'cessation of functions' within the UDDA.
- Exploration of the implications of different interpretations on death determination.
Main Results:
- The UDDA contains two distinct and conflicting interpretations of 'cessation of functions'.
- One interpretation focuses on spontaneous functions, while the other includes artificially supported functions.
- These differing interpretations render the UDDA conceptually inconsistent.
Conclusions:
- The UDDA's inconsistency could lead to paradoxical conclusions regarding the definition of death.
- Conscious individuals on artificial support might be considered dead, or those with irreversible brain destruction alive.
- Resolving these inconsistencies is crucial for accurate and ethical death determination.
Abstract:
The Uniform Determination of Death Act (UDDA) provides that "an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead." We show that the UDDA contains two conflicting interpretations of the phrase "cessation of functions." By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency.
