Revise the Uniform Determination of Death Act to Align the Law With Practice Through Neurorespiratory Criteria

Neurology. 2022 Mar 29;98(13):532-536. doi: 10.1212/WNL.0000000000200024. Epub 2022 Jan 25.


Although the Uniform Determination of Death Act (UDDA) has served as a model statute for 40 years, there is a growing recognition that the law must be updated. One issue being considered by the Uniform Law Commission's Drafting Committee to revise the UDDA is whether the text "all functions of the entire brain, including the brainstem" should be changed. Some argue that the absence of diabetes insipidus indicates that some brain functioning continues in many individuals who otherwise meet the "accepted medical standards" like the American Academy of Neurology's. The concern is that the legal criteria and the medical standards used to determine death by neurologic criteria are not aligned. We argue for the revision of the UDDA to more accurately specify legal criteria that align with the medical standards: brain injury leading to permanent loss of the capacity for consciousness, the ability to breathe spontaneously, and brainstem reflexes. We term these criteria neurorespiratory criteria and show that they are well-supported in the literature for physiologic and social reasons justifying their use in the law.

MeSH terms

  • Brain Death* / diagnosis
  • Brain Stem
  • Brain*
  • Consciousness
  • Humans
  • United States