Lewis Ariane
Division of Neurocritical Care, Departments of Neurology and Neurosurgery, New York University Langone Medical Center, 530 First Avenue, Skirball-7R, New York, NY, 10016, USA.
Neurocrit Care. 2022 Oct;37(2):377-385. doi: 10.1007/s12028-022-01567-3. Epub 2022 Jul 19.
In response to concerns about the declaration of death by neurologic criteria, the Uniform Law Commission created a drafting committee to update the Uniform Determination of Death Act (UDDA) in the Fall of 2021. One of the key questions for the committee to address was the following: Should the revised UDDA address objections to the use of neurologic criteria to declare death? This article (1) provides historical background and survey results that demonstrate the need to address this question; (2) summarizes the ethical principles that support and oppose accommodation of objections to the use of neurologic criteria to declare death; (3) reviews accommodation in other areas of medicine and law; (4) discusses existing legal and hospital guidance on management of these objections; (5) examines perspectives of stakeholder medical societies and expert health care professionals, lawyers, ethicists, and philosophers on whether the revised UDDA should address these objections; (6) identifies some questions for the drafting committee to consider when deciding whether the revised UDDA should address objections to the use of neurologic criteria to declare death; and (7) summarizes the potential downstream effects of the drafting committee's decision.
针对对基于神经学标准判定死亡的相关担忧，统一法律委员会于2021年秋季成立了一个起草委员会，以更新《统一死亡判定法》（UDDA）。委员会需要解决的关键问题之一如下：修订后的UDDA是否应回应对于使用神经学标准判定死亡的反对意见？本文（1）提供了历史背景和调查结果，以证明有必要解决这一问题；（2）总结了支持和反对顺应对于使用神经学标准判定死亡的反对意见的伦理原则；（3）回顾了医学和法律其他领域的顺应情况；（4）讨论了关于处理这些反对意见的现有法律和医院指南；（5）审视了利益相关方医学协会以及专家医疗保健专业人员、律师、伦理学家和哲学家对于修订后的UDDA是否应回应这些反对意见的观点；（6）确定了起草委员会在决定修订后的UDDA是否应回应对于使用神经学标准判定死亡的反对意见时需要考虑的一些问题；以及（7）总结了起草委员会决定可能产生的下游影响。
