CHEST Guidelines-The-US-Uniform-Determination-of-Death-Act

The-US-Uniform-Determination-of-Death-Act_chest

Pdf Summary

In a recent exchange in the journal <em>CHEST</em>, two critical discussions arose regarding brain death, particularly around religious objections to determining death by neurologic criteria (DDNC), also known as brain death. The first piece by Thaddeus Mason Pope clarifies misconceptions in a prior article by JM Luce. Pope highlights that New York does not allow families to reject DDNC entirely on religious grounds—a possibility that New Jersey legislation provides. Instead, New York mandates "reasonable accommodation" of religious objections, requiring hospitals to continue physiological support for a limited duration (24 to 72 hours) after declaring brain death. Pope also points out Illinois, alongside New York and California, mandates such accommodations, contrasting New Jersey’s broader exemptions.

The second discussion, by Greg Yanke and colleagues, examines the potential constitutional challenges to the US Uniform Determination of Death Act (UDDA) in cases like Jahi McMath's. They address whether laws mandating DDNC can withstand challenges based on religious freedom, referencing the <em>Employment Division, Department of Human Resources v. Smith</em> decision, which upheld a neutral law not intended to restrict religious practices. However, the Religious Freedom Restoration Act (1993) demands laws not infringe religious exercise without serving a compelling government interest by the least restrictive means. This potentially complicates the UDDA’s position, especially as many states adopt similar religious freedom statutes.

Both pieces highlight the nuanced legal and ethical landscapes involved in reconciling medical standards with religious beliefs. While reasonable accommodation laws are less challenging to implement, they remain interpretive, shifting with different state guidelines, and are not entirely free of potential litigation risks. These debates emphasize the need for clearer regulations and demonstrate how discussions about ethical and legal frameworks must evolve to accommodate diverse viewpoints.

Keywords

brain death

religious objections

neurologic criteria

reasonable accommodation

Thaddeus Mason Pope

Greg Yanke

Uniform Determination of Death Act

Religious Freedom Restoration Act

constitutional challenges

ethical frameworks