Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed Revision.
Discrepancies between the Uniform Determination of Death Act (UDDA) and the adult and pediatric diagnostic guidelines for brain death (BD) (the "Guidelines") have motivated proposals to revise the UDDA. A revision proposed by Lewis, Bonnie and Pope (the RUDDA), has received particular attention, the...
| Published in: | Journal of Medicine & Philosophy Vol. 48; no. 5; pp. 453 - 478 |
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| Format: | Article |
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Oxford University Press / USA
Oct2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=hlh&AN=172332000&site=ehost-live header: @attributes: shortDbName: hlh uiTerm: 172332000 longDbName: Humanities International Complete uiTag: AN controlInfo: bkinfo: jinfo: jid: 03605310 MPS jtl: Journal of Medicine & Philosophy issn: 03605310 maglogo: N pubinfo: dt: Oct2023 vid: 48 iid: 5 pid: 622 pub: Oxford University Press / USA artinfo: ui: 172332000 10.1093/jmp/jhab014 ppf: 453 ppct: 25 formats: fmt: – @attributes: type: T – @attributes: type: P size: 363KB tig: atl: Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed Revision. aug: au: Shewmon, D Alan affil: University of California Los Angeles , Los Angeles, California , USA su: Proof & certification of death Brain death Bioethics Judgment (Psychology) Child patients Faith Hypothalamus sug: subj: Proof & certification of death Brain death Bioethics Judgment (Psychology) Child patients Faith Hypothalamus keyword: apnea test brain death diagnostic guidelines hypothalamic function informed consent medical standard Uniform Determination of Death Act (UDDA) ab: Discrepancies between the Uniform Determination of Death Act (UDDA) and the adult and pediatric diagnostic guidelines for brain death (BD) (the "Guidelines") have motivated proposals to revise the UDDA. A revision proposed by Lewis, Bonnie and Pope (the RUDDA), has received particular attention, the three novelties of which would be: (1) to specify the Guidelines as the legally recognized "medical standard," (2) to exclude hypothalamic function from the category of "brain function," and (3) to authorize physicians to conduct an apnea test without consent and even over a proxy's objection. One hundred seven experts in medicine, bioethics, philosophy, and law, spanning a wide variety of perspectives, have come together in agreement that while the UDDA needs revision, the RUDDA is not the way to do it. Specifically, (1) the Guidelines have a non-negligible risk of false-positive error, (2) hypothalamic function is more relevant to the organism as a whole than any brainstem reflex, and (3) the apnea test carries a risk of precipitating BD in a non-BD patient, provides no benefit to the patient, does not reliably accomplish its intended purpose, and is not even absolutely necessary for diagnosing BD according to the internal logic of the Guidelines; it should at the very least require informed consent, as do many procedures that are much more beneficial and less risky. Finally, objections to a neurologic criterion of death are not based only on religious belief or ignorance. People have a right to not have a concept of death that experts vigorously debate imposed upon them against their judgment and conscience; any revision of the UDDA should therefore contain an opt-out clause for those who accept only a circulatory-respiratory criterion. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y custom: © 2019 Journal of Medicine and Philosophy Inc.. item: Journal of Medicine & Philosophy holder: Oxford University Press / USA dt: @attributes: year: 2023 holdings: @attributes: islocal: N |
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