Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
22-19-167(a)
UAGA good faith immunity
Yes
22-19-177 (Immunity)
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
22-19-181 and 22-19-182.
Nurse DCD pronouncement
Yes
UDDA good faith immunity
Yes
22-31-4
Anatomical Gift Act
When does FPA take effect?
After death.
(Does not specify brain death vs. circulatory death; Alabama's UDDA determines what constitutes death)
22-19-161 (3)
Is revocation of FPA after death allowed?
No
22-19-167(a)
Does the UAGA include a good faith immunity clause?
Yes
22-19-177 (Immunity)
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
22-19-181 and 22-19-182.
Determination of Death
Types of death referenced in the UDDA
Death by Circulatory and Respiratory Criteria.
Death by Neurological Criteria (Brain Death).
Deaths which must be pronounced by a physician
Brain death (neurological criteria)
How many brain death declarations are required?
Only for donation potential are two separate physicians needed to declare brain death.
Could nurse pronouncement in DCD be possible?
Yes
Since the physician requirement specifically applies to neurological criteria, Donation after Circulatory Death (DCD) pronouncement might be performed based on institutional policy.
Does the UDDA include a good faith immunity clause?
Yes
22-31-4
Pediatric Nuances & Insights
Any individual who is 18 or older may make an anatomical gifts. Minors who are emancipated or authorized to get a driver’s license (at least 16 years old) can also legally authorize their own donations. For individual under 18, when a child passes away in a hospital, the staff notifies Legacy of Hope, the state’s only federally designated organ procurement organization. Specially trained coordinators work directly with parents or legal guardians to obtain consent. If parents are divorced, the parent with legal custody makes the decision. (Section 22-19-163)
Unique Nuances to Note
The decision of a registered donor cannot be overturned after death.
Healthcare is managed state by state. Each state has its own version of the Uniform Anatomical Gift Act (UAGA), which outlines the rules around the gift of organs, eyes and tissues, as well as its own version of the Uniform Determination (or Declaration) of Death Act (UDDA).
In general, the majority of states have adopted the Revised UAGA, which emphasizes the legally binding nature of First Person Authorization (FPA) for donation. In most states FPA takes effect after death, at which point the decision cannot be revoked or amended. One must then review how that state determines a person to be dead under its UDDA. The exception is minors, where in most instances a parent can change the minor’s decision.
There can be nuances within state laws that differ from state to state. An effort has been made to highlight some of them here, however this reference is not all inclusive. It is highly advised to read each state’s UAGA and UDDA thoroughly for clarity.
This legislative reference guide is not intended to serve as legal advice. For further detailed questions, please contact your local OPO. For any inaccuracies or corrections, please contact The Alliance at info@organdonationalliance.org.