Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
4-506 (a)
UAGA good faith immunity
Yes
4-514 (The section is called "Liability")
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
4-518 and 4-519
Nurse DCD pronouncement
Yes
UDDA good faith immunity
Unknown
Anatomical Gift Act
When does FPA take effect?
After death.
(Type of death is not specified and UDDA determines types of death.)
4-501 (c)
Is revocation of FPA after death allowed?
No
4-506 (a)
Does the UAGA include a good faith immunity clause?
Yes
4-514 (The section is called "Liability")
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
4-518 and 4-519
Determination of Death
Types of death referenced in the UDDA
Respiratory and circulatory death.
Brain death.
Deaths which must be pronounced by a physician
Not specified.
How many brain death declarations are required?
One brain death 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 who is emancipated or at least 15 years and 9 months old (the age at which they may apply for a learner’s permit) may register as an organ donor. If the minor is not emancipated, a parent or legal guardian may make the anatomical gift decision on the child’s behalf. (Section 4-503)
State Education Initiatives, Recommendations & Requirements
Maryland includes organ, eye, tissue donation education as part of the driver education curriculum.
Unique Nuances to Note
Maryland maintains a statutory donor registry. Designating a donor through the Motor Vehicle Administration (MVA) or the registry is a legally recognized gift. (Section 4-516)
Maryland specifically provides that an anatomical gift made by will becomes effective at death even if the will is never probated. Furthermore, if the will is later invalidated, the anatomical gift itself is still valid. (Section 4-503)
Maryland amended its law to allow donors to specify particular purposes for donation. A donor may designate that an anatomical gift be used for transplantation, therapy, research and education purposes. (Section 4-509)
In the hierarchy of decision-makers, guardians of the decedent at time of death are listed above the spouse. Domestic partnership and places them on the same level as the spouse. (Section 4-507)
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.