Determining the moment of death remains of singular importance for ethically assessing organ donation. Our Observatory has published many articles about this issue. A recent study discusses the issue, with particular reference to Lewis and colleagues’ recent proposition to the revision of the Uniform Determination of Death Act (UDDA) and change the current legal definition of death which specifies that “death occurs when an individual has sustained irreversible cessation of both circulatory and neurological functions.” The proposition of Lewis and al. to resolve death moment debated in the scientific community says “The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination.”

Death moment debated. Rebuild the public trust should be an urgent priority

The Linacre Quarterly journal study entitled Does the Uniform Determination of Death Act Need to Be Revised?  shows that this revision is fraught with difficulties. “Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust.”

A more coherent biological foundation is claimed

In this respect an article published in Hasting Center on the same topic goes a step forward:

“Medicine declares itself to be a science, or at least to be guided by science. Therefore, its concept of death must be a scientific, biological concept that is justified by empirical evidence and the usual standards of scientific evaluation, such as coherence with other well-accepted scientific claims, unification under a common ontological framework, simplicity, and so on. Accordingly, the medical determination of death should not attempt to identify conditions for human death other than biological death, such as loss of personhood.”

And the authors continue, “We contend that the way to revise the UDDA is to drop entirely the neurological determination of death, relying instead on a much simpler formulation limited to the first part of the UDDA: “An individual who has sustained irreversible cessation of circulatory and respiratory functions is dead.” The policy implications of abandoning the neurological determination of death, which we and others have addressed elsewhere, are complex, but they need to be faced for determination of death to be based on a coherent biological foundation.” Hasting Center January 23, 2020

Our bioethical statement

In our view, however, the most thought-provoking point of the debate is one that refers to the issue of organ donation: “The interests of the donor as a person are paramount, and no interest of organ recipients or of the greater society can justify the negation of the rights and bodily integrity of the person who is a donor”. Statment we support from the beginning of the debate based on scientific evidence.