Three major Catholic organizations and one of the largest physician organizations in the United States are warning the American public about a national proposal to redefine what constitutes being legally dead and its implications for card-carrying organ donors and the transplant industry.
The Uniform Law Commission (ULC), an influential national organization that recommends legislation to all 50 states, has introduced changes to the Uniform Death Determination Act (UDDA), that would amend the definition of brain death to partial brain death or what Dr. Joseph Meaney, President of the National Catholic Bioethics Center (NCBC) described to The Epoch Times as “not really dead.”
“This is very, very serious,” said Dr. Meaney, “ because once you’ve been determined to be so-called dead, then many things can happen to you, one of which is they can take organs for transplantation off a person who isn’t really dead,” said Meaney, “It’s not acceptable from an ethical perspective. But it’s also kind of scary for people who are considering being organ donors.”
His group, along with the National Conference of Catholic Bishops, issued a joint statement this week against the proposal in anticipation of the ULC’s plans to work on the proposed USSA revisions this weekend at its annual conference in Honolulu.
The American College of Physicians (ACP) and the Catholic Medical Association have also issued warnings about the proposed redefinition of death.
The ULC did not respond to inquiries right away about the proposed changes to the Uniform Death Determination Act, often referred to as the “Death Act.”
The idea to revise the Death Act came about last year when Neurology published a paper written by a group of medical professors who argued that the existence of some brain function should not stand in the way of declaring someone legally dead when there is no hope the patient will ever be able to regain consciousness.
In their published argument, entitled “Revise the Uniform Determination of Death Act to Align the Law With Practice Through Neurorespiratory Criteria."
The panel said that the existence of bodily functions like the release of hormones, has created a legal roadblock for doctors to determine a person with brain death is legally dead under the current version of the Death Act.
“Neurologists agree that this lingering release of hormones isn’t a clinical sign of life and, therefore, shouldn’t prevent a death declaration, Adam Omelianchuk, an Assistant Professor for Center for Medical Ethics & Health Policy at Baylor College of Medicine, said in the article, ”But because that isn’t spelled out in current law, he said, there is “a kind of gray zone” about which clinicians, the public and the legal community have demanded clarity.”
David Magnus, Director of the Stanford Center for Biomedical Ethics, further argued in the paper that a person who has sustained irreversible cessation of just circulatory and respiratory functions” is just as dead as a patient who sustained irreversible cessation of all functions of the entire brain.
In its eight-page draft proposing to revise the UDDA, the ULC has proposed adopting new terminology that would allow patients who still have partial brain function to be declared legally dead.
Dr. Meaney said one of the most significant is the proposal to replace the use of the term “irreversible” with “permanent” in declaring someone is legally dead.
It discusses declaring a person in a permanent coma as legally dead under the redefinition of what constitutes death. A person with some brain function but unable to breathe on their own could also be declared legally dead under the proposed revisions.
The group opposed to changing the Death Act says they are especially concerned that the proposed protocols would legally permit attending doctors to “actively occlude blood flow to the brain” for organ harvesting purposes.
“Under this controversial protocol, the transplant team could directly cause the death of the donor,” the NCBC and NCCB wrote in their statement.
In a letter outlining her group’s concerns, Dr. Jan Carney, ACP’s Chairman of the Ethics, Professionalism and Human Rights Committee, also said she is very concerned about the real motivation behind the UDDA change.
“Also of concern is the extent to which issues of organ transplantation and organ availability seem to be influencing efforts to modify the UDDA,” Dr. Carney wrote.
The move to relax the medical definition of death comes at the heels of a major pledge by the Biden Administration to modernize organ procurement in the United States.
It is a multibillion-dollar industry regulated by a quasi-government agency known as the Organ Procurement and Transplant Network (OPTN)
In March, as part of that pledge, Biden’s Health Resources and Services Administration (HRSA), announced the “Organ Procurement Transplantation Network Modernization Initiative.”
The Biden Administration has earmarked $67 million in taxpayer dollars in the 2024 budget to bolster organ procurement, more than double the funding of the program in the fiscal year 2023 budget.
In a July 20 press release, one day ahead of the ULC Conference on a proposal to relax the standards for determining someone legally dead, The United Network for Organ Sharing (UNOS) hailed the Biden initiative as a long overdue answer to improving organ procurement.
“As long as there is a waitlist, it is our moral obligation to ensure we are promoting progress and increasing equitable access to lifesaving transplants,” said UNOS CEO Maureen McBride, “Patients and families are counting on us to pursue improvements that increase transparency, strengthen accountability, and save more lives. We support calls for patient-focused improvements and want to be part of the solution.”
Dr. Meaney said if the transplant industry wants more accountability, he questions why there isn’t a call for better testing to determine if someone has actually experienced irreversible brain death.
He pointed out that the test to determine if someone is brain dead does not run any tests on the hypothalamus, which he pointed out regulates not just the hormones cited by the Stanford panel—but several other potential “signs of life.” including body temperature, body fluids, brain chemicals heart rate, hunger pains, moods and several glands like the pituitary.
“And of course, if [the] hypothalamus is functioning in a person, then a person hasn’t had irreversible cessation of brain activity,” said Dr. Meaney, “So, obviously, they don’t really fit the definition.”
