In a sign of things to come, Nevada has
amended the Uniform Determination of Death Act (UDDA). Expect other states to make similar amendments soon. On Friday, June 2, Governor Sandoval signed A.B. 424.
The UDDA requires that clinicians determine brain death in accordance with guidelines set forth by either the American Academy of Neurology or the Pediatric Section of the Society of Critical Care Medicine. The statute identifies the guidelines by name: “Evidence-based Guideline Update: Determining Brain Death in Adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology” and “Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations.”
Furthermore, recognizing that the guidelines might be updated, the statute preserves flexibility. It requires that clinicians determine brain death in accordance with the “subsequent revisions approved” by the guidelines authors.
Explicitly referencing specific guidelines eliminates the need to determine whether these guidelines qualify as “accepted medical standards.” This has been a significant problem. Since adoption of the UDDA in the early 1980s, there has been significant variability in the brain death determination guidelines followed by hospitals across the United States.
At least in Nevada, that variability should be eliminated by the new statute. By unambiguously identifying which guidelines are authoritative, the statute eliminates uncertainty over which medical standards are “accepted.”
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.