Clinical & Organizational Ethical Considerations in Determining Death and Its Role in Organ Donation Public Deposited

In 1981 the United States Uniform Determination of Death Act (UDDA) expanded the legally recognized forms of death to either (1) the irreversible cessation of circulatory and respiratory functions, or (2) the irreversible cessation of all functions of the entire brain. The second and new definition is most commonly referred to as death by neurological criteria or brain death. Both cardiopulmonary and brain death are intricately linked to organ transplantation, and the supply of organs. In the US, donation after brain death is the source of the majority of organs. It is also more likely to result in multiple transplantable organs from a single donor, and is currently the only dependable source for heart transplants. Since the UDDA, the legal definition of death has remained unchanged, but there continues to be public and academic controversy regarding the processes surrounding death and organ transplantation. The history of the legal and ethical determination of death is deeply intertwined with the history of organ procurement and transplantation and these interdependent processes result in medico-legal inquiries in addition to a variety of organizational and clinical ethical considerations. Some specific considerations include societal and organizational constitution of death, the public perception of death and the role it plays in defining death, and the role of organ donation and procurement with the withdrawal of life support.

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