Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
29.2-16.1-7(a)
UAGA good faith immunity
Yes
29/2-16.1-17
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
29-2-16.1-21
Nurse DCD pronouncement
Yes
UDDA good faith immunity
Unknown
Anatomical Gift Act
When does FPA take effect?
After death.
(Specific type of death is not specified and UDDA determines types of death)
29-2-16.1-1(3)
Is revocation of FPA after death allowed?
No
29.2-16.1-7(a)
Does the UAGA include a good faith immunity clause?
Yes
29/2-16.1-17
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
29-2-16.1-21
Determination of Death
Types of death referenced in the UDDA
Respiratory and circulatory death.
Neurological (brain death).
Deaths which must be pronounced by a physician
Not specified.
How many brain death declarations are required?
One brain death declaration is needed.
Could nurse pronouncement in DCD be possible?
Yes
Does the UDDA include a good faith immunity clause?
Unknown
Pediatric Nuances & Insights
A minor may make an anatomical gifts if they are emancipated or at least 16 years old and legally eligible to apply for a driver’s license. If the minor is not emancipated, a parent or legal guardian may make the anatomical gifts decision on the minor’s behalf. (Section 29-2-16.1-3, Section 9-24-17-7)
State Education Initiatives, Recommendations & Requirements
Indiana Code Section 20-30-5-16 requires all public high schools in indiana include instruction on human organ and blood donation in their health education curricula.
Unique Nuances to Note
Indiana has a very important timing ule. The OPO must make every effort to determine donor potential within about 2 hours after hospital contact. The hospital can withdraw life support under the donor’s declaration / advance directive if the OPO has not made that determination within 6 hours. (Section 29-2-16.1-20)
Indiana’s immunity clause is also more specific than those of many other states; it protects healthcare providers who follow an unrevoked anatomical gift directive from a donor, and hospitals and recovery agencies that make good-faith determinations about written gifts or revelations. (Section 29-2-16.1-17)
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
Some doctors allow their Advanced Practice Providers (APPs) to perform the brain death examination instead of the physician doing it personally.