ACP Revises Standard on Cardiorespiratory Death Determination
9 Oct 2023 • The American College of Physicians (ACP) has issued a new position paper on determination of death that includes a clarification to the 1981 Uniform Determination of Death Act (UDDA), but otherwise reaffirms the current standards.
The clarification replaces the word "irreversible" with "permanent" with regard to the cessation of circulatory and respiratory functions but retains "irreversible" to describe brain death.
Other than the change from "irreversible" to "permanent," the paper reinforces the tenets of the existing UDDA by stating the following positions:
- Position 2 supports maintaining circulatory and whole brain (neurologic) standards for determining death as separate, independent standards.
- Position 3 supports retaining the whole brain standard for determining death according to neurologic criteria and opposes "higher brain" function standards.
- Position 4 recommends that the medical tests used for determining death align with standards of death determination, not vice versa, and that the language of the UDDA that a "determination of death must be made in accordance with accepted medical standards" be maintained without changes.
- Position 5 states that determination of death is a distinct issue from organ transplantation and reaffirms the fundamental ethical importance of the dead donor rule.
- Position 6 recommends that additional education be directed toward physicians and other clinicians, and the general public, regarding determination of death and communication about death and the dying process.
The position paper was published online in the journal Annals of Internal Medicine.
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