The method of determination of death and the timing of death is not specified in either of the Uniform Anatomical Gift Acts. Each state, however, has a Determination of Death Act, usually a version of the Uniform Determination of Death Act, which addresses this issue. The Uniform Determination of Death Act, developed in 1980, was another effort of the NCCUSL. The Michigan Determination of Death Act, for example, provides that an individual is dead, if that individual has sustained either “[i]rreversible cessation of circulatory and respiratory functions,” or “[i]rreversible cessation of all functions of the entire brain, including the brain stem. Such a determination is to be made “in accordance with accepted medical standards.” The method of ascertaining when these conditions of death have been met therefore is left to physicians, and this method is left open to change as medical science evolves. Obviously, solid organ transplants would not be feasible had the brain death criteria not been added to the more traditional definition of death—irreversible cessation of circulatory and respiratory function. The addition of the brain death definition allows the removal of usable organs, without the removal being considered to be the cause of the patient’s death.

States may have specific cornea removal statutes, which have been enacted either prior to, or in addition to the UAGA. These statutes authorize corneal removal by the medical examiner or his or her designee without permission of the next-of-kin, or even notification of the next-of-kin in certain circumstances. Generally, if an autopsy has been authorized to be done by the county medical examiner, and the medical examiner has no knowledge of any objection to corneal removal by the next-of-kin of the decedent, the corneas may be removed without notification of the next-of-kin. As in the case of decedents with valid organ donor cards and no consent of a relative, organ procurement agencies generally will not, as a matter of policy, seek tissue in these cases despite the legality of the tissue harvest.

The 1968 Act, while facilitating organ donation, did not actively encourage donation. In order to more actively encourage organ and tissue donation, most states adopted “routine inquiry/required request” laws in the mid-1980s. These statutes prescribed specific protocols for the timely request of organ and tissue donations. These state statutes have now been preempted by Federal law mandating routine request (described in the next section).