Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
2715
UAGA good faith immunity
Yes
2716(d) and 2726
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
Nurse DCD pronouncement
No
UDDA good faith immunity
Yes
1768
Anatomical Gift Act
When does FPA take effect?
After death.
(Type of death was not specified, UDDA determines types of death)
2710(4) and 2713(a)
Is revocation of FPA after death allowed?
No
2715
Does the UAGA include a good faith immunity clause?
Yes
2716(d) and 2726
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
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
Circulatory and Respiratory Death.
Neurological (Brain Death).
How many brain death declarations are required?
One brain death declaration is needed
Could nurse pronouncement in DCD be possible?
No
Does the UDDA include a good faith immunity clause?
Yes
1768
Pediatric Nuances & Insights
A minor may make an anatomical gift with parental consent. However, a married minor may make an anatomical gift without parental consent. (Section 2711)
State Education Initiatives, Recommendations & Requirements
The Delaware Organ and Tissue Donor Awareness Board sponsors an annual video scholarship contest for high school students to create public service announcements on organ and tissue donation. The whole purpose of this program is to educate teenagers about donation and encourage informed conversations before they become eligible to register as donors. Click here for more information
Unique Nuances to Note
Section 2715 describes that only the individual who designated themselves to be a donor can actually make the changes to their decision and there are various ways they can do so. This means that once the patient is deceased, no further changes to their decision can be made. (Section 2715)
A minor may make an anatomical gift with parental consent. However, a married minor may make an anatomical gift without parental consent. (Section 2711)
In the hierarchy of decision-makers, after the category of “any other person authorized or obligated to dispose of the decedent’s body, a hospital administrator or their designee are listed as the last possible decision-maker” (Section 2711 c).
The UAGA specifies the mandated reporting of the potential donor by the hospital to the OPO, medical record reviews required by OPOs and support of the hospital of the donation process (Section 2721).
A confidentiality requirement is specifically stated (Section 2722).
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.
Other Comments
Verbiage states “A determination of death pursuant to this section must be made by a person certified to practice medicine under this chapter…” This probably indicates that only a physician can determine death in either instance, respiratory and circulatory criteria or neurological criteria.
Delaware law requires that a determination of death be made by a licensed medical doctor based on generally accepted medical standards; this applies to both circulatory and respiratory criteria and brain deaths.