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Doctors Sound Alarm Over Proposed Changes to Definition of Death in Federal Guidance

Doctors Sound Alarm Over Proposed Changes to Definition of Death in Federal Guidance

The proposed changes to the Uniform Definition of Death Act would allow comatose patients to be declared dead for use as organ donors.

Amid all the other changes to biological classification we have been treated to under the Biden administration, one is proposed involving the definition of death that is now drawing concern.

The Uniform Determination of Death Act (UDDA) has been in guidance in place since 1981. The UDDA states:

An individual who has sustained either irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brainstem, is dead. A determination of death must be made in accordance with accepted medical standards.”

Late last year, a group of lawyers and “experts” met to discuss revisions to the UDDA.

A group of lawyers as well as observers including neurologists and philosophers met Friday and Saturday to discuss potential revisions to the determination. The group, part of the Uniform Law Commission, also addressed updating policies surrounding the notification of families about the process for determining death.

…Brain death is a legal designation in all 50 states. How brain death is determined, which tests are used and the type of physician qualified to make the determination can vary by state, said Thaddeus Mason Pope, a law professor at Mitchell Hamline School of Law in St. Paul, Minn.

In recent years, families have objected to doctors conducting brain-death evaluations on their loved ones. Some have filed lawsuits challenging brain-death determinations. And some doctors and lawyers have said guidelines for determining brain death don’t require tests for the loss of function in every part of the brain, such as the hypothalamus, which regulates hormones. The gap between the legal determination of brain death, they said, and the way doctors interpret it could erode public trust.

Prof. Pope and two colleagues in 2020 co-wrote an article in the Annals of Internal Medicine calling for revisions to the Uniform Determination of Death Act to address these and other challenges. .

We have been treated to three years of disastrous consequences when scientific “experts” and their legal supporters decided to implement policy without proper vetting of what they propose. Let’s take a look at the new definition to see if there is reason to worry.

An individual who has sustained either (a) permanent cessation of circulatory and respiratory functions or; (b) permanent coma, permanent cessation of spontaneous respiratory functions, and permanent loss of brainstem reflexes, is dead. A determination of death must be made in accordance with accepted medical standards.

Heidi Klessig, M.D. (a retired anesthesiologist and pain management specialist) and Christopher W. Bogosh (a psychiatric mental health registered nurse) are observers of the Uniform Law Commission on the RUDDA. They sounded the alarm about the proposed revision.

Notice that the new neurological standard under (b) does not use the term “irreversible,” nor does it include the loss of whole-brain function. The term “permanent” is being defined to mean that physicians do not intend to act to reverse the patient’s condition.

Thus, people in a coma whose prognosis is death will be declared dead under this new standard. An unresponsive person with a beating heart on a ventilator is not well, but he is certainly not dead!

…In addition, the AAN proposes that there be no requirement for informed consent before initiating brainstem-reflex testing. One of the tests is called the apnea test. During this exam, the patient is removed from the ventilator for 8–10 minutes, attempts to breathe are monitored, and carbon dioxide in the blood is measured.

This test has absolutely no benefit for the patient. It can only cause harm, as rising levels of carbon dioxide in the bloodstream cause an increase in intracranial pressure, which is hugely detrimental for a brain-injured patient. The idea that there will be no informed consent requirement for this potentially harmful exam violates the ethical principles of autonomy, justice, beneficence, and non-maleficence.

There are concerns changes to the UDDA are focused on elements that would support the organ donation process and be detrimental to the rights of patients and their families.

The current guidance may not be perfect. But the current proposal’s direction is truly disturbing, though completely aligned with the destructive choices that our policymakers continue to make.

NOTE AND CORRECTION: The post has been updated and corrected to reflect the following the nature of the proposed changes:

The Uniform Declaration of Death Act was drafted in 1981 by a President’s Commission study on brain death. It was approved by both the American Medical Association (AMA) and the American Bar Association (ABA) shortly after its publication

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Comments

Yeah, this is not an accidental oversight.

healthguyfsu | April 11, 2023 at 5:14 pm

IMO This is more about making health care more affordable and available (freeing up hospital beds) than organ donation.

    gonzotx in reply to healthguyfsu. | April 11, 2023 at 6:32 pm

    Your kidding right?

    BierceAmbrose in reply to healthguyfsu. | April 11, 2023 at 8:55 pm

    Except for, you know, the cost of lives not had by the non-dead declared dead; distrust and anxiety of family and friends during treatment; treatments forgone with loss of life and health-span to stay out of the medicos hands.

    It’s easy to reduce costs when you get to pick what counts.

      CommoChief in reply to BierceAmbrose. | April 11, 2023 at 10:36 pm

      All that plus making everyone to reconsider however briefly remaining or becoming an organ donor. Some will decide to drop their participation. The medical community really has no idea the level of distrust created by their actions or lack during Rona. There will be a long period of overhang. Longer still if the decision makers among them continue to refuse to admit their errors with the same public and vigor they used to demonize the skeptical who, we now know were correct more often than not.

        Martin in reply to CommoChief. | April 12, 2023 at 9:07 am

        One problem is they can’t admit errors since they didn’t make mistakes they made overt decisions to force things that didn’t have enough evidence to be decided except at a individual level. They refused to look for treatments so they could force things. I suppose these could be called errors but they were not mistakes they were done on purpose.

        WTPuck in reply to CommoChief. | April 12, 2023 at 11:07 am

        Yup. Considering revoking my consent to organ donation now. I will definitely revoke it if this change goes through. Not an easy decision since a family member benefitted from organ donation, and a friend is currently awaiting a donation.

        If the government is removed from making organ donation decisions at any point in the process, I may reconsider.

In the socially binding Democrat manner, I hereby identify as ALIVE, until personally revoked.
Take that, you cheating, dementia-ridden mommafracker.
If those Social Security checks stop, you’d better watch out.

Planned Patienthood (PP). Planned Parent/hood (PP) in Michigan, New York et al. Pelosi’s precedent (PP), too? A progressive path and grade.

That said, six weeks to baby… fetal-baby meets granny in biological and legal state. Viable from conception until Her or her Choice.

“completely aligned with the destructive choices that our policymakers continue to make”
Exactly, Well, more like “part and parcel of the destructive choices that our policymakers have been making with increasing frequency from the start of the Obama presidency, with a brief pause in the increase during the Trump years.”

Great they gonna harvest the organs and use the rest to make Soylent Green. /s?

All about the Benjamin’s, Dr and hospital make HUGE wampum with organ harvesting

    henrybowman in reply to gonzotx. | April 11, 2023 at 7:56 pm

    Everyone makes oodles of money from organ donation, except the original organ owner.
    Because it’s “unethical for him to profit from the sale of his organs!”
    And ethics are way important to the fedguv, so they passed a law against it!
    Bwa ha ha ha ha ha ha ha ha!
    You think the “white guilt” hustle began with the Obama candidacy?
    And if you checked the box on your driver’s license, you been hustled.

    Idonttweet in reply to gonzotx. | April 11, 2023 at 8:09 pm

    First question: What was it about the current definition and law that needs to be “fixed?”

    Second question: Who stands to profit from the change? (If in doubt, check to see how much doctors and hospitals were paid to treat COVID patients opposed to influenza patients.)

    Third question: Is the change in the best interests of the patient?

      memyselfandi in reply to Idonttweet. | April 12, 2023 at 10:53 am

      1/) The lack of clarity on how to determine brain death that was leading to an unfortunate number of useless lawsuits and a massive amount of unnecessary pain inflicted on the deceased’s close relatives, in addition to the desecration of corpses.
      2) No one.. Hospitals got a 10% premium for treating covid patients. Doctor’s got diddly squat. This wouldn’t have covered the extra costs caused by such a highly infectious disease. Hence the reason hospital bankruptcies exploded in 2020. Maybe stop getting all of your information from professional liars?

smalltownoklahoman | April 11, 2023 at 6:34 pm

Yeah, that’s not a good proposed change! Let’s hope it gets rejected and they stick with the old definition!

I imagine people volunteering their organs just got less popular…..

    It won’t be long before you no longer have a say about organ donation (or much else). They want to use human bodies for parts (as here), for compost, and for food. They’re already talking about ALL of that, and when they run out of naturally dead people, they will have to find ways to increase the supply. Thus the push for “involuntary suicide” via euthanasia, along with a host of other efforts like the one outlined in this post. Not enough dead people? Let’s just expand the definition of “dead,” and we all know they never stop expanding definitions or their reach.

      “”Thus the push for “involuntary suicide” via euthanasia,””

      And, of course, that’s already in effect in some European countries.

Shortest path through the thesaurus from life to death:

life animation excitement commotion mayhem destruction death

focuses on the big picture.

China has a looser definition.

We are entering the world of THX 1138 where everything has a social/financial value. Exceed the budget and face termination. Having “conquered” the womb with abortion, time to deal with the other “leeches” of the system.. the old and infirmed. whatever the age. Social/financial Darwinism.

I agree with the whole brain issue. There are suitable tests that can look at the whole brain. Just too tempting to harvest first and deflect questions later.

Right.

Next step: redefine “accepted medical standards.” My bet is on Fauci to do the redefining.

BierceAmbrose | April 11, 2023 at 8:59 pm

“The proposed changes to the Uniform Definition of Death Act would allow comatose patients livestock to be declared dead for use as organ donors.”

“Patients”, being people, are alive on their own terms for their own sake. Livestock are alive or not for their keepers value of the herd, in their terms, not the livestock’s.

Biden and Harris seem kinda dead, don’t they? So does Pelosi and McConnell and Feinstein.

Some ghoul of a doctor or other scientist recently proposed that we use the bodies of people in comas, or brain dead, (I can’t recall which), as incubators for childless couples–the left just keeps going down the road to genocide, death, and destruction

    SophieA in reply to rochf. | April 12, 2023 at 12:03 am

    In the 70s, I read the book, COMA, in which surgical patients were purposely put into a coma during an “accidental surgical anesthesia mistake” for the purpose of having “fresh” organs for transplants.

    What you describe elevates this evil to a whole new ugly level.

    I cannot believe that horror has come true. Monstrous!

Antifundamentalist | April 12, 2023 at 12:21 am

So this clears the way for insurance companies to deny coverage on life support after a certain point – whatever point Medicare sets as the “standard.”

Time to review any health care directives or living wills you have signed. Remember too that hospital ethics panels often rule against patients and families when the hospital believes a patient should not continue on support.

“I’m getting better!”
“No you’re not you’ll be stone dead in a moment.”
“I can’t take ‘im like that, it’s against regulations!”

Another Voice | April 12, 2023 at 3:51 am

Promotion of Euthanasia as a means to an end has been getting much more press in the last few years. More so now that Canada has fully embraced promoting legal euthanasia as an end to means of controlling their costs of their government Health Care system. Much as it came to be in England where all public health is administered by the government from birth to death. This is where Obamacare wanted to go when introduced. We are now getting very close to being a total Medicare or Medicaid Health Program and one of the ways to keep expenses manageable is to lower the bar for what constitutes death. Just not the medical side but the payout in Social Security benefits which the government doesn’t fund even though every person with a paycheck deduction says otherwise. The sooner people die the total and final payout from the government has been and remains at $200.00.
That-that-that’s All-l-l-l…Fo-o-lks!!

    memyselfandi in reply to Another Voice. | April 12, 2023 at 10:56 am

    “More so now that Canada has fully embraced promoting legal euthanasia as an end to means of controlling their costs of their government Health Care system. ” Why are you such an extremely dishonorable liar.

I never submitted my DNA to those companies that will tell you all about yourself for that very reason. If you happen to be a perfect organ match to some VIP, they will use that new definition of death on you.

American Human | April 12, 2023 at 9:06 am

I’ve often wondered, why a person, or their family, cannot sell their organs after they are dead.

Okay, so it’s against the law. If it is so unethical to sell an organ, why do the doctors, nurses, staff, hospital, et al. get paid?

I’m an adult healthy person, what if someone needs a kidney, why cannot I offer my kidney at a reasonable price. It seems as if the organ price would be the least expensive part of the whole process.

Okay, if I’m dead, why can’t my wife or family sell my organs, heart, lungs, liver, kidneys, etc., and make some money to offset the cost of my funeral or just to supplement their income?

Why is that illegal?

It’s amazing how in all of these comments no one pointed out to the grossly incompetent author of this piece that these laws are solely state laws. The body making this proposal is composed of people solely appointed by state governments. The Biden administration and the federal government is not involved in any way shape or form.

Some 25 years ago, the woman who would ultimately be my mother in law, was declared to be in a coma that she would never wake up from. Her husband and daughter, ignoring medical advice, moved her home, talked to her a lot, and she indeed did wake up. She is now over 90, and still lives there to this day, with her younger daughter now helping to take care of her. But for most of that 25 years, she was fine.

Rupert Smedley Hepplewhite | April 13, 2023 at 8:54 am

Hmmmmm, something in my antique memory keeps pinging the phrase “Death Panels”. I wonder who first spoke of that. 🤔