Uniform Anatomical Gift Act (UAGA) & Uniform Determination of Death Act (UDDA)
At a glance
Revocation of FPA after death
No
68.64.070(1)
UAGA good faith immunity
Yes
68.64.170
Coroner / ME role in UAGA
Yes
OPO must obtain ME release
Yes
68.64.190
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)
68.64.010(3)
Is revocation of FPA after death allowed?
No
68.64.070(1)
Does the UAGA include a good faith immunity clause?
Yes
68.64.170
Does the UAGA give instructions for the coroner / Medical Examiner role?
Yes
Must the OPO obtain release from the coroner / Medical Examiner?
Yes
68.64.190
Determination of Death
Types of death referenced in the UDDA
Death by Respiratory and Circulatory Criteria
Death by Neurological Criteria (Brain Death)
Deaths which must be pronounced by a physician
The UDDA does not clearly state that a physician must declare brain death. However the language immediately above the UDDA on the same page asserted that brain death testing is expected to be performed by a physician.
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
If an unemancipated minor dies, a parent can revoke or amend the anatomical gift of the minor, or they can also revoke the minor’s refusal to donate (Section 68.64.070 (7)-(8)).
State Education Initiatives, Recommendations & Requirements
State-approved driver education courses are required include instructional material developed by the Department of Licensing and Washington’s federally designated organ procurement organization relating to organ and tissue donation awareness education. (Section 308-108-150 (11))
Unique Nuances to Note
Washington state recognizes domestic partners as being equivalent to spouses in the donatin hierarchy. (Section 68.64.080 (b))
Washington state does not include ‘a person who expressed special care or concern in the hierarchy of decision-makers’. (Section 68.64.080 (1))
Washington state requires OPOs to provide interpreter services when discussing donation with families who have limited english proficiency or if english is not their first language. (Section 68.64.130)
If an unemancipated minor dies, a parent can revoke or amend the anatomical gift of the minor, or they can also revoke the minor’s refusal to donate (Section 68.64.070 (7)-(8)).
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.