A survey of American neurologists about brain death: understanding the conceptual basis and diagnostic tests for brain death.

Annals of Intensive Care
Ari R JoffeAllan Decaen

Abstract

Neurologists often diagnose brain death (BD) and explain BD to families in the intensive care unit. This study was designed to determine whether neurologists agree with the standard concept of death (irreversible loss of integrative unity of the organism) and understand the state of the brain when BD is diagnosed. A previously validated survey was mailed to a random sample of 500 board-certified neurologists in the United States. Main outcomes were: responses indicating the concept of death that BD fulfills and the empirical state of the brain that would rule out BD. After the second mailing, 218 (44%) surveys were returned. Few (n = 52, 27%; 95% confidence interval (CI), 21%, 34%) responded that BD is death because the organism has lost integrative unity. The most common justification was a higher brain concept (n = 93, 48%; 95% CI, 41%, 55%), suggesting that irreversible loss of consciousness is death. Contrary to the recent President's Council on Bioethics, few (n = 22, 12%; 95% CI, 8%, 17%) responded that the irreversible lack of vital work of an organism is a concept of death that the BD criterion may satisfy. Many responded that certain brain functions remaining are not compatible with a diagnosis of BD, including EEG act...Continue Reading

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Citations

Oct 12, 2012·HEC Forum : an Interdisciplinary Journal on Hospitals' Ethical and Legal Issues·Mohamed Y Rady, Joseph L Verheijde
Feb 3, 2016·Der Nervenarzt·W Heide
Jul 25, 2014·Journal of Critical Care·Jack K Kilcullen
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Software Mentioned

Statistical Package for the Social Sciences ( SPSS
REDCap Survey

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