Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
8613 (e)
UAGA good faith immunity
Yes
8616(c)
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
8626 and 8626.1 and 8626.2
Nurse DCD pronouncement
Yes
UDDA good faith immunity
Unknown
Anatomical Gift Act
When does FPA take effect?
After death
(The type of death is not specified, as it is determined under the UDDA)
8601 (definition of "Anatomical gift")
Is revocation of FPA after death allowed?
No
8613 (e)
Does the UAGA include a good faith immunity clause?
Yes
8616(c)
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
8626 and 8626.1 and 8626.2
Determination of Death
Types of death referenced in the UDDA
Death by Respiratory & Circulatory Criteria
Death by Neurological Criteria (Brain Death)
Deaths which must be pronounced by a physician
No specific roles are specified for pronouncement of either type of 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?
Unknown
Pediatric Nuances & Insights
A minor who is 16 years or older may make an anatomical gift with parental or guardian consent, which must be noted on the donor document or driver’s license application. (Section 8611)
State Education Initiatives, Recommendations & Requirements
The Department of Education, in consultation with designated organ procurement organizations, should develop and post a model curriculum on organ donation for grades 9–12. Public and nonpublic schools may use the curriculum, and parents or guardians may opt their child out by written notice.(Section 8627.1)
Unique Nuances to Note
Under the PA law, a gift of the entire body is generally invalid unless it is made in writing at least 15 days before death or unless consent is obtained from the next of kin. In certain blended family situations, consent from adult children who are not the surviving spouse’s children might also be needed. Such detail is not commonly found in state UAGAs. (Section 8611 (a))
Under PA law, vascularized composite allografts such as hands, facial tissue, limbs, are not included in the definition of an anatomical gift and require separate authorization. (Section 8601 and 8656)
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.