The Enigma of Brain Death

This is a commentary on an historical analysis by Anne E. Clinton in the Hastings Center Report's November-December 2025 issue on the creation of the Uniform Determination of Death Act in 1980, focusing on the attempt by the Uniform Law Commission to revise the act in 2020. The original UDDA was based on scientific evidence that the brain is responsible for maintaining the integrated functioning of the body, such that brain death quickly leads to the biological death of the person. During the deliberations, however, it became clear that this was not scientifically correct and that biological life can continue for years after the diagnosis of brain death. This commentary argues that this new understanding of brain death generated intractable disagreement among the commissioners, leading the committee to abandon its efforts in 2023. The commentary closes with how the impact of this failure to revise the act will affect clinical practice and organ transplantation in the years to come.