Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
2108.09 (A)
UAGA good faith immunity
Yes
2108.19
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
2108.25 & 2108.26 & 2108.261 & 2108.262 & 2108.263 & 2108.264 & 2108.265 & 2108.266 & 2108.267
Nurse DCD pronouncement
No
UDDA good faith immunity
Yes
2105.35 (2) and (3)
Anatomical Gift Act
When does FPA take effect?
After death.
(The type of death is not specified, as it is determined under the UDDA)
2108.01 (C)
Is revocation of FPA after death allowed?
No
2108.09 (A)
Does the UAGA include a good faith immunity clause?
Yes
2108.19
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
2108.25 & 2108.26 & 2108.261 & 2108.262 & 2108.263 & 2108.264 & 2108.265 & 2108.266 & 2108.267
Determination of Death
Types of death referenced in the UDDA
Death determined by neurological criteria.
Death based on permanent cessation of circulatory and respiratory functions.
Deaths which must be pronounced by a physician
For both respiratory and circulatory criteria, and neurological criteria (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
2105.35 (2) and (3)
Pediatric Nuances & Insights
An emancipated minor or a minor who is at least 15 years and 6 months old and eligible to apply for a temporary instruction permit may make an anatomical gift. A parent may make a gift for an unemancipated minor. A parent may also amend or revoke the gift if the unemancipated minor dies. (Section 2108.04 and 2108.06)
State Education Initiatives, Recommendations & Requirements
Ohio law requires classroom driver education must include information or instruction on organ donation and its procedures using materials approved by the Second Chance Trust Fund Advisory Committee. Students may be excused for religious reasons with written parental or guardian notice. (Section 4508.021)
Unique Nuances to Note
Ohio places the obligation on first responders including law enforcement officers, firefighters, EMA personnel who believe a person is death or near death to make a search for any donor document or other evidence evidence of donor status and forward it to the hospital if found anything. (Section 2108.12(A)-(B))
Once a person authorizes organ donation through their driver’s license or ID donor registry, Ohio law emphasizes that the donor does not need to re-authorize at each renewal. The authorization will be effective until withdrawn. (Section 2108.05(C))
A former spouse generally loses the right to make post-mortem decision after a divorce or legal separation unless the relevant document states otherwise. (Section 2108.76)
Section 2108.75 and 2108.77 stated the circumstances in which a surrogate decision-maker loses their authority. These circumstances include becoming unavailable, being disqualified, being unwilling to serve, or otherwise no longer meeting the statutory requirements to act on behalf of their deceased loved ones. (Section 2108.75 and 2108.77)
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
Section (2) of the UDDA emphasizes that a physician must determine death based on Division (A). Since division (A) include both death by circulatory ad respiratory criteria and death by neurological criteria (brain death), it appears that a physician is required to declare death in either situation.