The following report was compiled using information provided by Dr. Paul A. Byrne and Dr. Heidi T. Klessig. Dr. Byrne has been a Clinical Professor of Pediatrics at the University of Toledo, College of Medicine for decades, as well as a writer and speaker on “brain death”, organ donation, and much more. Dr. Klessig, a retired anesthesiologist, is a speaker and writer who co-authored Harvesting Organs & Cherishing Life: What Christians Need to Know About Organ Donation and Procurement. Videos of Dr. Byrne and Dr. Klessig are available at https://halovoice.org/organ-donation/.

In August of 1968, an ad hoc committee of physicians at Harvard Medical School wrote a landmark paper that defined people in irreversible coma as dead. This utilitarian pronouncement was made to skirt the ethical and legal issues involved in procuring organs from people who were biologically alive (i.e., have a beating heart, respiration, blood circulation, and other signs of life). In 1981, the Uniform Determination of Death Act (UDDA) codified into law the Harvard committee’s recommendations. 

The UDDA provides two definitions of death: 1) irreversible cessation of circulatory and respiratory functions (a.k.a. “cardio-pulmonary death”) and 2) irreversible cessation of all functions of the brain, including the brainstem (a.k.a. “brain death”). According to Dr. Byrne, “Neither requires evidence of destruction that is the morally and medically certain way to ensure ‘irreversible’ loss of functions and change in state to death.” This law allows people who are alive to be killed for their healthy organs. 

Proposed Revisions to the UDDA Will Make Matters Worse 

Dr. Byrne states, “The UDDA and Proposed Updates are seriously inadequate if a determination of death is to be the signal for excision of a person’s vital organs, autopsy, embalming or cremation, which are certain, if a mistake has been made, to kill the still-living patient.” 

Dr. Klessig (“¹Revisions to the UDDA Considered by the Uniform Law Commission”) explains the proposed changes to the UDDA, including a crucial change in wording. “The 

first change would seek to replace the term irreversible in the standards with the term permanent. ‘Irreversible’ is commonly held to mean ‘not capable of being reversed.’ The term ‘permanent’ is being offered as meaning that ‘no attempt will be made to reverse the situation.’ Since doctors will not attempt to correct the person’s problem, it becomes permanent rather than irreversible. Thus, people whose prognosis is thought to result in death will be viewed as dead before they die.” 

Dr. Byrne points out other problems with the revised UDDA: 

• It would exclude testing of some functions of the brain, such as that part of the brain that controls thyroid function. Testing and treating low thyroid could possibly save the life of the so-called “brain dead” patient. 
• It would take away the rights of patients or their families to prevent declarations of “brain death”. 
• It would allow “brain death” determination to be done without notifying relatives and surrogates. Thus, it would take away from loved ones and surrogates the possibility to decline or consent to the dangerous apnea test. (The apnea test includes disconnection from the ventilator for 10 minutes or longer, causing carbon dioxide to increase. Rising levels of carbon dioxide in the blood cause intracranial pressure to rise, further damaging the already traumatized brain. This test has no benefit for the brain-injured patient, only potentially lethal effects.) 

Dr. Klessig warns, “If adopted, the revisions will uphold an unethical law that euthanizes registered organ donors, most of whom gave uninformed consent for the medical procedure to the Department of Motor Vehicles (DMV) window attendant years prior.” 

Protecting Innocent Human Life 

Dr. Byrne advises repeal and replacement of the UDDA with this model statute that protects life until true death: “No one shall be declared dead unless respiratory and circulatory systems and the entire brain have been destroyed. Such destruction shall be determined in accord with universally accepted medical standards.” [²Byrne P.A., et al, “Brain Death—the Patient, the Physician, and Society,” Gonzaga Law Review 18:3 (1982/83): 429-516] This definition of death is solidly based medically and ethically. 

The model statute should also require that full and complete information about any tests used to determine “brain death” be provided to families and surrogates with the freedom to decline tests and refuse determinations of “brain death”. Furthermore, the ideal law would require that treatment options aimed at protecting and preserving the life of the patient be offered and not denied based on quality-of-life judgments made by caregivers, even though patients or their surrogates may refuse them on the basis of being extraordinary. 

The Uniform Law Commission (ULC) is reviewing the proposed revisions to the UDDA, and its report should be forthcoming by the end of this year. Please contact ULC members and urge them to repeal and replace the UDDA with the model statute that will protect life until true death. 

Contact: The Honorable Samuel Thumma, Chairman Members of the Determination of Death Act Committee 

Uniform Law Commission 111 N. Wabash Avenue, Suite 1010, Chicago, IL 60602 [email protected], (312)450-6600 

For more Information visit Dr. Paul A. Byrne’s website at www.lifeguardianfoundation.org 

Citations 

¹Heidi T. Klessig, MD, “Revisions to the UDDA Considered by the Uniform Law Commission”, https://www.respectforhumanlife.com/post/ revisions-to-the-udda-considered-by-the-uniform-law-commission-ulc?utm_campaign=06c46d53-0d0a-43ea-9244-31281a4a31d8&utm_ source=so&utm_medium=mail&cid=41644b5e-ea30-49b0-b592- 1209065d9ad9 

²D. Alan Shewmon, MD, “Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed Revision”, https://academic.oup.com/jmp/advance-article-abstract/doi/10.1093/ jmp/jhab014/6275576