The legislative history of the Uniform Determination of Death Act (UDDA) is replete with statements about the importance of uniformity. Natural-language processing algorithms now may help read new virus mutations, especially helpful with #COVID19. The bill already passed the Assembly last month. 215-877-2660 … 424 which amends the Uniform Determination of Death Act (UDDA) in response to the Aden Hailu case and other recent challenges to brain death. Among other things, we must revisit condition 5. v. |CONTROVERSIES IN THE DETERMINATION OF DEATH 2 standing doubts about the standard’s biological basis, fueled by more recent clinical observations about patients diagnosed as “brain dead,” have reignited the debate about the standard’s validity. amended the Uniform Determination of Death Act (UDDA). It requires that clinicians determine brain death in accordance with the “subsequent revisions approved” by the guidelines authors. This project investigated public perception and understanding of key ethical and policy questions associated with Rapid Organ Recovery (ROR), which … Definition of Death – The REVISED Uniform Determination of Death Act. The UDDA requires that clinicians determine brain death in accordance with guidelines set forth by either the American Academy of Neurology or the Pediatric Section of the Society of Critical Care Medicine. James M. DuBois, DSc, PhD Principal Investigator; Amy Waterman, PhD Co-Investigator; Ana Iltis, PhD Co-Investigator; DESCRIPTION. With the development of technologies that allow scientists to study how individual neurons … Read more at www.bioethics.net (An Act Relating to the Determination of Death, 2017 Nev. Acts ch. This included application of Grading of Recommendations Assessment, Development, and … demonstrated either on the traditional grounds of irreversible cessation of heart and lung functions or on the basis of irreversible loss of all functions of the entire brain. Report of the Medical Consultants on the Diagnosis of Death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research  Unknown author (1982-01) Related Items in Google Scholar ©2009—2020 Bioethics Research Library ... ©2009—2020 Bioethics Research Library Box 571212 Washington DC … But that cessation would not be irreversible. The family of Israel Stinson continues its lawsuit asking a federal court to declare that the California Uniform Determination of Death Act is unconstitutional. Corresponding Author. Only two of 56 U.S. jurisdictions address the question in statute or regulation. Medical Futility Blog. KEY PERSONNEL. In 1990, Thomas K. Donaldson sued the California Attorney General for the right to an elective premortem cryopreservation. ALBERT GARTH THOMAS. @IChotiner of The New Yorker speaks with immunologist Barry Bloom to discuss what goes into making decisions on vaccine distribution. Of course, cryopreservation may not work. The goal of this first phase was to focus on the biology of death and the dying process while bracketing legal, ethical, cultural, and religious perspectives. Posts tagged Determination of Death Bioethics on Air: Episode 36: Philosophical Perspectives on Brain Death—with Dr. Melissa Moschella. The reason for this is the fact that there is still reticence as regards this concept in the public and academic spheres. Brain death is a legal fiction used to justify ending lives prematurely. The National Catholic Bioethics Center. But the remaining 16 jurisdictions have adopted substantially similar rules judicially or legislatively. Guidelines for the Determination of Death. In their Bioethics Forum Essay1, Miller and Nair-Collins criticize Lewis and colleagues’ recent publication in the Annals of Internal Medicine2 that calls for revision of the Uniform Determination of Death Act (UDDA). Controversies in the Determination of Death Letter of Transmittal. the INDEPENDENT reports that “the concept of ‘brain death’ or death by neurological criteria, known as DNC, was introduced 40 years ago, but doctors have different ideas of what this means. Report of the Medical Consultants on the Diagnosis of Death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research  Unknown author (1982-01) Related Items in Google Scholar ©2009—2020 Bioethics Research Library ... ©2009—2020 Bioethics Research Library Box 571212 Washington DC … What, then, does it mean to say that the ventilator “externally supports the vital functions of breathing and circulation?” It means that, in the place of the … will call for the international community to establish a universal definition of DNC and a universal way to diagnose it. On Friday, June 2, Governor Sandoval signed, The bill was a direct response to the problems identified by the Nevada Supreme Court in the Aden Hailu case. The appropriate phraseology here is “the determination of death using neurological criteria.” + 2. Since then, the practice of transplanting organs from the … They contend only that Jahi does not (as a matter of fact) satisfy the CUDDA standards. Cambridge: Cambridge University Press. Healy Hall, 4th Floor
 Georgetown University 37th & O Streets NW Washington, DC, 20057
 United States Of America, Unfortunately for Donaldson, the Santa Barbara trial court and an appellate court. In 1981, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research released its seminal report, Defining Death. The UDDA requires that clinicians determine brain death in accordance with guidelines set forth by either the American Academy of Neurology or the Pediatric Section of the Society of Critical Care Medicine. the INDEPENDENT reports that “the concept of ‘brain death’ or death by neurological criteria, known as DNC, was introduced 40 years ago, but doctors have different ideas of what this means. Overconfidence, poor planning and ignored warnings felled the world’s richest nations. They do not attack the (legal) validity of the standards themselves. FAQs and Summaries The National Catholic Bioethics Center May 11, 2020 Determination of Death, Brain Death, Organ Donation, Catholic Health Care, Persistent Vegetative State (PVS), End-of-Life Issues, Nutrition and Hydration Explicitly referencing specific guidelines eliminates the need to determine whether these guidelines qualify as “accepted medical standards.” This has been a significant problem. Click here to access our original and reposted COVID-19 pieces, The American Journal of Bioethics Retweeted, Clinical Trials and Human Subjects Research, Coronavirus; Pandemic; Ethics; Public Health, Culture / Ethnicity / Gender / Disability, Culture Diversity Inclusion Race Social Justice, Disability, Chronic Conditions and Rehabilitation, Fordham University Center for Ethics Education, Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute, Ben Bramble, Visiting Fellow, Princeton University, 8th International Congress on Infectious Diseases, 17th International Conference on Nephrology and Hypertension. Controversies in the Determination of Death: A White Paper by the President's Council on Bioethics . The hearing is scheduled for August 11. amended the Uniform Determination of Death Act (UDDA). Today is the start of Euroanaesthesia 2017: The European Aneasthesiology Conference.One notable talk by Giuseppe Citerio is “Brain death definition: is brain dead…dead enough?” Outside this one talk. Controversies in the Determination of Death The President's Council on Bioethics Washington, D.C. January 2009 Chapter Seven: A Summary of the Council's Debate on the Neurological Standard for Determining Death A Double Standard for the Determination of Death. The determination of death criteria recognized in jurisdictions across the United States have raised complex medical, legal, and ethical issues, largely based on the prevailing respect for a moral framework known as the DDR. Controversies in the Determination of Death. It is the report … Yes. https://www.axios.com/pharmacy-deserts-cities-prescriptions-45c32271-37ac-4105-b1bb-e2d2436b88c1.html. Syndicated from: Medical Futility Blog Contrast the claims made by the family of Jahi McMath. In the second of a two-part series on brain death, Dr. Melissa Moschella joins Joe Zalot to discuss how “irreversible loss of organismal self-integration” offers a valid philosophical basis for determining death. My analysis of Nevada’s recent amendment to the Uniform Determination of Death Act (UDDA) is now Online First at the  Journal of Bioethical Inquiry: “New Legal Guidelines for Determination of Brain Death.”. http://ow.ly/rlC750D9S3i, "The first year of the Covid-19 pandemic revealed that a country’s wealth would not spare it from the virus. The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University. Legally, he would have never been dead. Among members of the President's Council on Bioethics, the prevailing opinion is that the current neurological standard for declaring death, grounded in a careful diagnosis of total brain failure, is biologically and philosophically defensible. That was a crime in California and the courts found (like state appellate courts everywhere in the USA) that there was no constitutional violation in applying that law to Donaldson’s situation.But why was the case framed as a right to assisted suicide? ... and an affiliate of the department of population health in the division of bioethics. Clinical and ethical perspectives on brain death Michael Nair-Collins Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA Abstract: Death determined by neurological criteria, or brain death, is an accepted legal standard for death throughout much of the world. The President's Council on Bioethics released a white paper on “Controversies in the Determination of Death” in 2008. This post appears in the June issue of the American Journal of Bioethics. This doctrine was codified in 1981 in the Uniform Determination of Death Act (UDDA), which declares, “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.”. @genomics_policy https://www.tandfonline.com/doi/full/10.1080/15265161.2020.1863516, With efficacious medications available, ethics considers who has access to these drugs and who is at risk of losing them. These case law samples suggest the courts’ inability to reach a conclusion as to what is the status of an embryo. A determination of death shall be made using either of two criteria: 1.1 Cardiopulmonary criteria - In the absence of artificial cardiopulmonary support, death is determined by … In: ... Pluralistic policy of determination of death: A report on public views. For example, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research emphasized the importance of eliminating the “harm that is risked by diversity”. While the UDDA should not specify all the “medical criteria and tests,” it can and must do more than address the “general physiological standards.” There is a middle ground where the UDDA can specify the source or identity of the authoritative medical criteria and tests without including their precise content. The second case is that of Marlise Muñoz, a pregnant patient, also declared brain dead and whose physicians decided to maintain life support measures (connection to a respirator, and maintenance of other treatments), based on the fact that the survival of the foetus was at stake. But it seems that factual predicate was not carefully examined. by The whole point of cryogenic preservation is that sometime in the future, when a cure for Donaldson’s disease is found, then his body may be “reanimated.” If true, then he would not be brought back from the dead. That is how the family of Israel Stinson frames its argument in a new brief filed in a California federal court, last week.Israel Stinson’s family is challenging the constitutionality of the California Uniform Determination of Death Act (CUDDA). B.Z. Based largely on Shewmon’s evidence, the President’s Council on Bioethics issued a report in 2008 ( The President’s Council on Bioethics, 2008) rejecting the loss of somatic integration rationale for considering brain death to be a sign of human death. Controversies in the Determination of Death The President's Council on Bioethics Washington, D.C. January 2009 Chapter Six: Non-Heart-Beating Organ Donation . The Incoherence of Determining Death by Neurological Criteria: A Commentary on "Controversies in the Determination of Death", a White Paper by the President's Council on Bioethics: en: ... Citation migrated from OpenText LiveLink Discovery Server database named EWEB hosted by the Bioethics Research Library to the DSpace collection EthxWeb hosted by DigitalGeorgetown. The conclusion that death of the brain is a valid criterion for determining the death of a human being has been criticized by those who assert that sufficient bodily integration remains following death of the brain ( table 1) to view such individuals as living human organisms. 315 (A.B. In Determining Death by Neurological Criteria, Matthew Hanley offers both a practical and a philosophical defense. en: ... ©2009—2020 Bioethics Research Library Box 571212 Washington DC 20057-1212 This view denies that any higher metaphysical or functional level is relevant to the consideration of death (i.e., it asserts that all … http://ow.ly/l98D50D5nUt, Target Article on multi-omic privacy is out in AJOB @bioethics_net. The President's Council on Bioethics has recently released a report supportive of the continued use of brain death as a … 424. In so doing it has given support to the neurological standard that total brain failure is the standard upon which to assess whether an organism is dead. The President’s Council on Bioethics 1425 New York Avenue, NW, Suite C100 Washington, DC 20005 December 2008 The President The White House Washington, DC Dear Mr. President: I am pleased to present to you a white paper by the President’s Council on Bioethics entitled Controversies in the Determination of Death. However, in recent years, litigation challenging the use of neurologic criteria to declare death has questioned the authority of the UDDA. Professor Bernat refers to two recent cases in which the diagnosis of brain death led to clinical-ethical-care problems that emerged in the media and public opinion. But as I recently argued in the. Under #COVID19, there has been an increase in "pharmacy deserts", where people struggle to fill medications locally. Since 1981, the Uniform Determination of Death Act (UDDA) has served as the legal foundation for the medical practice of determining death. The Uniform Law Commission indicates that 40 of 56 jurisdictions have adopted the UDDA. In: The … Posted on April 5, 2020 at 5:00 AM. The President's Council on Bioethics Washington, D.C., December 2008 . CONTINUING THE DEFINITION OF DEATH DEBATE: THE REPORT OF THE PRESIDENT'S COUNCIL ON BIOETHICS ON CONTROVERSIES IN THE DETERMINATION OF DEATH. Jahi’s parents refused to accept the diagnosis of death and requested that the patient’s treatment is maintained, as they did not consider her dead. ... As was noted in Chapter One, the neurological standard for the determination of death was formulated in the 1960s, in the early years of successful cadaveric organ transplantation. Marlise’s family asked that these support measures be withdrawn since Marlise was considered clinically and legally dead. In practice, death is pronounced in China within tens of seconds after … The hearing is scheduled for August 11. In response to these issues, the President’s Council white paper, “Controversies in the determination of death”, attempts to bring some definition to this question. Since the Uniform Determination of Death Act requires irreversibility, it seems that premortem  cryopreservation does not cause death. 424 which amends the Uniform Determination of Death Act (UDDA) in response to the Aden Hailu case and other recent challenges to brain death. We, once again, thank Miller and Nair-Collins for contributing to the discussion on this topic and reiterating the need for modifications to the UDDA. The statute identifies the guidelines by name: “Evidence-based Guideline Update: Determining Brain Death in Adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology” and “Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations.”. In 1981, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research released its, Definition of Death – The REVISED Uniform Determination of Death Act. [embedded content]. The neurological criteria for the determination of death remain controversial within secular and Catholic circles, even though they are widely accepted within the medical community. by Thaddeus Mason Pope, JD. Letter of Transmittal to the President ... Chapter Seven: A Summary of the Council's Debate on the Neurological Standard for Determining Death; Personal Statements: Alfonso Gómez-Lobo, Dr. … The Uniform Determination of Death Act (1980) was the mechanism to satisfy these conditions. In so doing it has given support to the neurological standard that total brain failure is the standard … http://ow.ly/TAwi50D9Sy4, A big component of vaccine distribution has been utilizing ethics to determine vaccine prioritization. However, brain death has also been a source of controversy ever since its inception, and … Contrast the claims made by the family of Jahi McMath. Expect other states to make similar amendments soon. The President’s Council on Bioethics 1425 New York Avenue, NW, Suite C100 Washington, D.C. 20005 January 2009 The President The White House Washington, D.C. Dear Mr. President, I am pleased to present to you a white paper by the President's Council on Bioethics entitled Controversies in the Determination of Death . Because the area of harvesting embryonic stem cells remains significantly undefined, both legally and morally, there are vastly different opinions between researchers and bioethicists, mainly because of ethical limitations, on the rights that should be granted to cells with the potential to develop into human beings and the consequences of neglecting significant scientific research or advancement. Brain death is a legal fiction used to justify ending lives prematurely. The persistence of controversies in relation to the concept of brain death is striking, although it is over 40 years since the birth of this concept of death of the person, published in the Journal of the American Medical Association (JAMA) in 1968 (2). The customary criteria for determining death are "cardio-pulmonary," i.e., death is declared after breathing and heart-beat cease. Click here to access a complete archive of posts written by our Original Bioethics.net Authors! University of Queensland – Philosophy, Australia. Definition Death has occurred when there is irreversible cessation of all functions of the entire brain, including the brain stem. en  This item appears in the … Since adoption of the UDDA in the early 1980s, there has been significant variability in the brain death determination guidelines followed by hospitals across the United States. All these topics are contentious and when one topic arises, they begin to comingle. The Bioethics Defense Fund ( www.BDFund.org) is a public interest organization whose mission is to put law in the service of human life via model legislation, litigation, and … By unambiguously identifying which guidelines are authoritative, the statute eliminates uncertainty over which medical standards are “accepted.”. #bioethics The President's Council on Bioethics Washington, D.C. January 2009 . Profoundly grateful to my brilliant collaborator Eline M. Bunnik @ErasmusMC for hard work and tenacity on this one. But Donaldson wanted to act before a malignant tumor destroyed his brain.Unfortunately for Donaldson, the Santa Barbara trial court and an appellate court rejected Donaldson’s claims. Roe v. Wade[i]) or the categorization of embryos as property (i.e. In late May, the State of California filed a motion to dismiss the family’s third ame…, Some authors, as Bernat reports in his article, have come to classify brain death unscientifically, illogically, even treating it as a legal fiction. It is time to revise the Uniform Determination of Death Act (UDDA) to assure a consistent nationwide approach to consent for brain death testing. In 1981, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research released its seminal report, Defining Death. by Medical Futility Blog. In Determining Death by Neurological Criteria, Matthew Hanley offers both a practical and a philosophical defense. Expect other states to make similar amendments soon. The case was dramatized in a 1990 episode of LA LAW. The bill was a direct response to problems identified by the Nevada Supreme Court in the Aden Hailu case. On Friday, June 2, Governor Sandoval signed A.B. This doctrine was codified in 1981 in the Uniform Determination of Death Act (UDDA), which declares, “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the … The neurological criteria for the determination of death remain controversial within secular and Catholic circles, even though they are widely accepted within the medical community. They do not attack the (legal) validity of the standards themselves.The Stinson family argues that “the biological basis for brain death is hotly disputed and central to this case.”  They allege that Israel remained alive AFTER an official death certificate was issued. The courts construed his request as one for assisted suicide. The President's Council on Bioethics Washington, D.C. January 2009 . Furthermore, we believe that the UDDA should specify the medical standards for determination of death by neurologic criteria. The 1980 Uniform Determination of Death Act (UDDA) provides comprehensive bases for determining death in all situations. Full Document (PDF) TABLE OF CONTENTS. The case was dramatized in a 1990 episode of LA LAW. A major appellate court decision from the United States seriously questions the legal sufficiency of prevailing medical criteria for the determination of death by neurological criteria. That is how the family of Israel Stinson frames its argument in a. Israel Stinson’s family is challenging the constitutionality of the California Uniform Determination of Death Act (CUDDA). They contend only that Jahi does not (as a matter of fact) satisfy the CUDDA standards. 6399 Drexel Road, Philadelphia, PA, 19151, United States. The State of California filed a motion to dismiss the family’s Third Amended Complaint on jurisdictional grounds. At least in Nevada, that variability should be eliminated by the new statute. Most cryopreservation is postmorterm. Chapter Three: The Clinical Presentation and Pathophysiology of Total Brain Failure ... D. Ventilator Support and Determination of Death . On May 23, 2017, the Nevada Senate passed A.B. Controversies in the Determination of Death The President's Council on Bioethics Washington, D.C. January 2009 Chapter Six: Non-Heart-Beating Organ Donation Davis v. Davis[ii], A.Z. Premortem Cryopreservation Does Not Cause Death, New Legal Guidelines for Determination of Brain Death, Brain Death: Legal Fiction Used to Justify Ending Lives Prematurely – Another California Lawsuit, California Uniform Determination of Death Act – Constitutional Challenge, Brain death: experts divided on how death is defined, Nevada Amends Uniform Determination of Death Act, International Conference to Better Define Brain Death, Nevada Senate Passes Bill to Amend Uniform Determination of Death Act, The Very Early Embryo & Its Moral Signifiance. Robert Truog, MD, joined contributors to the World Brain Death Project in presenting an international consensus report on the criteria for brain death diagnoses, or the determination of death by neurologic criteria (BD/DNC).The report, which was published in the Journal of the American Medical Association, addresses global inconsistencies in clinical guidelines surrounding BD/DNC, and … The Incoherence of Determining Death by Neurological Criteria: A Commentary on "Controversies in the Determination of Death", a White Paper by the President's Council on Bioethics  Miller, Franklin G.; Truog, Robert D. ( 2009-06 ) In commenting on these cases the bioethicists have stated, in no uncertain terms, that an individual correctly diagnosed as “brain dead” is dead, pure and simple.  Contrary to appearances of being alive, in reality the “brain dead” individual is a corpse.  These statements are misleading because they have ignored the long-standing controversy and debate in the professional … Donaldson’s cardiopulmonary functions and brain functions may cease. The current criteria for determination of death for execution by lethal injection (cessation of heartbeat, cessation of respiration, and dilated pupils) neither conform to current medical science nor to any standard of medical ethics. after Circulatory Determination of Death: A Pilot Study ... Bioethics Program 07/01/07 – 06/30/07. Controversies in the Determination of Death. Guidelines for the Determination of Death. 6399 Drexel … As technology and biological research continue to develop in the twenty-first century, it is necessary to address and further define the ethical considerations of embryonic research and the appropriate rights that may limit the extent of human research on zygotes, blastocysts, and fetal scientific advancement. Determination of Death: en: dc.subject.classification: Definition of Death (Bills, Laws, and Cases) en: dc.title: Determination of Death, Amendment: en: dc.provenance: Citation prepared by the Library and Information Services group of the Kennedy Institute of Ethics, Georgetown University for the ETHXWeb database. SASS, H. (1992): Criteria for death: Self-determination and public policy. Nevada Senate Passes Bill to Amend Uniform Determination of Death Act On May 23, 2017, the Nevada Senate passed A.B. A Double Standard for the Determination of Death. #bioethics. Is it appropriate to use neurological criteria to determine death? SUBJECT: DETERMINATION OF DEATH BY REPLACES: 08/2015 NEUROLOGIC CRITERIA PAGE: 1 of 2 _____ 1. The bill already passed the Assembly last month. There may be a mismatch between legal and medical standards for brain death, requiring the amendment of either or both. Given that the neurological criteria−the irreversible cessation of whole brain function−is the legally recognized criterion of death in many countries, including the United States [1], forthcoming advancements in neurotechnology under the BRAIN Initiative will be crucial to the accurate determination of death. They describe brain death as a “haphazard, uneven, and utilitarian-driven rush to declare patients dead, ignoring that possibility they might be alive.”. In their Bioethics Forum Essay1, Miller and Nair-Collins criticize Lewis and colleagues’ recent publication in the Annals of Internal Medicine2 that calls for revision of the Uniform Determination of Death Act (UDDA). We look forward to reading open peer commentaries! DUBOIS, J. M. & ANDERSON, E. E. (2006): Attitudes towards death criteria and organ donation among healthcare personnel and the general public. Current laws in the United States differ at the federal and state level, but there is no consistency in recognizing human embryos as humans, or affording them the same legal rights granted to a child; in fact, legal precedent actually detracts certain rights from developing embryos, favoring a human’s ability to destroy a potential human being (i.e. Objectives: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. I discussed that case, One notable talk by Giuseppe Citerio is “Brain death definition: is brain dead…dead enough?” Outside this one talk. 424) (effective Oct. 1, 2017)). Furthermore, recognizing that the guidelines might be updated, the statute preserves flexibility. Chapter Three: The Clinical Presentation and Pathophysiology of Total Brain Failure The National Catholic Bioethics Center. To their credit, Lewis and colleagues attempt to bolster the public trust in the medical profession by rectifying an unfortunate … They describe brain death as a “haphazard, uneven, and utilitarian-driven rush to declare patients dead, ignoring that possibility they might be alive.”The State of California filed a motion to dismiss the family’s Third Amended Complaint on jurisdictional grounds. [iii], Marriage of Dahl[iv], or Reber v. Reiss[v]). But now, money is translating into undeniable advantages." In response to these issues, the President’s Council white paper, “Controversies in the determination of death”, attempts to bring some definition to this question. Posts tagged Determination of Death Bioethics on Air: Episode 36: Philosophical Perspectives on Brain Death—with Dr. Melissa Moschella. The case was dramatized in a 1990 Episode of LA LAW a mismatch between legal medical. Death Bioethics on Air: Episode 36: philosophical Perspectives on brain Death—with Dr. Melissa Moschella these conditions sued. Provide insight into How we understand biological systems eliminates uncertainty over which medical for. To what is the status of an embryo an elective premortem cryopreservation they begin to comingle is after! 56 U.S. jurisdictions address the question in statute or regulation United States: Episode 36: philosophical on. Must revisit condition 5 virus mutations, especially helpful with # COVID19 v ].! 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