Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
C.26:6-84(8.a)
UAGA good faith immunity
Yes
C.26:6-91
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
C.26:6-94 and C.52:17B-88.7
Nurse DCD pronouncement
Yes
UDDA good faith immunity
Yes
26:6A-6
Anatomical Gift Act
When does FPA take effect?
After death.
(The type of death is not specified, as it is determined under the UDDA)
C.26:6-78(2)
Is revocation of FPA after death allowed?
No
C.26:6-84(8.a)
Does the UAGA include a good faith immunity clause?
Yes
C.26:6-91
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
C.26:6-94 and C.52:17B-88.7
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
Neurological (brain) death.
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?
Yes
26:6A-6
Pediatric Nuances & Insights
A minor who is 14 years of age or older may register as an organ donor, whether or not the minor is emancipated.
State Education Initiatives, Recommendations & Requirements
New Jersey requires all public schools to provide instruction on organ and tissue donation to students in grades 9-12 in their health curriculum. (Section 18A:7F-4.3)
Unique Nuances to Note
The Medical Examiner’s restrictions are limited and procedure based. If the death of the donor is under investigation, the Medical Examiner must carry out any examination, autopsy or tissue, organ analysis in a manner and within a timeframe that is compatible with preserving the organs. The Medical Examiner can only deny removal if the organs or tissues may be involved in determining the cause of death and must provide written reasons. (Section C.26:6B-12 and C.52:17B-88.7)
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
New Jersey has a separate death pronouncement statute allowing nurse pronouncement for circulatory and respiratory death. This is outside the UDDA. (Section C.26:6-8.1)
New Jersey’s law reference the American Academy of Neurology (AAN) guidelines as a resource for brain death determination (BDD). (Section C.26:6A-4)
New Jersey’s UDDA includes a religious objection provision. Death may not be declared using neurological criteria if doing so would violate the individual’s religious beliefs. (Section C.26:6A-5)
New Jersey protects insurance coverage when the religious exception is invoked. (Section C.26:6A-7)