Religious exemptions to death by neurologic criteria, as established by the 1981 Uniform Determination of Death Act, occur infrequently in the state of New Jersey, according to a study published in BMC Medical Ethics. Although infrequent, the study’s authors suggest that national and state policies are still needed to address these religious exemptions when they do occur.

In addition to searching literature and internet topics on religious objections to death by neurologic criteria, researchers from Northeastern University also contacted chaplains and heads of New Jersey hospital bioethics committees (n=53) for a research interview. Interview respondents were asked questions regarding death by neurologic criteria religious objections at their affiliated hospital. Questions focused on the frequency of these exemptions within the previous 5 years, the religion associated with these exemptions, and the incidences of denials of religious exemptions.

The final analysis included a total of 18 chaplains and New Jersey bioethics committee members who fully responded to the research interview. In the previous 5 years at the time of the interview, respondents reported 30 to 36 known exemptions and 5 religious exemptions to death by neurologic criteria at their affiliated hospital. Nonreligious reasons as well as reasons tied to the Orthodox Judaism tradition represented the primary factors that contributed to families seeking religious exemptions to death by neurologic criteria.

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A limitation of the analysis is its strict focus on instances of religious exemptions to death by neurologic criteria in New Jersey, which may mean these findings lack the ability to be extrapolated to other states.

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“Court rulings have not protected the religious freedom of patient families undergoing emotional ordeals when their loved one is declared dead by neurological criteria in a manner inconsistent with their religious beliefs,” the researchers wrote. “Ethical controversies surrounding brain death will continue to negatively affect patients and their families until they are resolved through consensus enforced by public policy.”


Son RG, Setta SM. Frequency of use of the religious exemption in New Jersey cases of determination of brain death. BMC Med Ethics. 2018;19:76.