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Anaesthesia May 2019
Topics: Brain Death; Canada; Critical Care; Humans; Professional Practice; Terminology as Topic; United Kingdom; United States
PubMed: 30671940
DOI: 10.1111/anae.14568 -
American Journal of Transplantation :... Mar 2017We sought to evaluate whether television and cinematic coverage of brain death is educational or misleading. We identified 24 accessible productions that addressed brain...
We sought to evaluate whether television and cinematic coverage of brain death is educational or misleading. We identified 24 accessible productions that addressed brain death using the archives of the Paley Center for Media (160 000 titles) and the Internet Movie Database (3.7 million titles). Productions were reviewed by two board-certified neurologists. Although 19 characters were pronounced brain dead, no productions demonstrated a complete examination to assess for brain death (6 included an assessment for coma, 9 included an evaluation of at least 1 brainstem reflex, but none included an assessment of every brainstem reflex, and 2 included an apnea test). Subjectively, both authors believed only a small fraction of productions (13% A.L., 13% J.W.) provided the public a complete and accurate understanding of brain death. Organ donation was addressed in 17 productions (71%), but both reviewers felt that the discussions about organ donation were professional in a paucity of productions (9% for A.L., 27% for J.W.). Because television and movies serve as a key source for public education, the quality of productions that feature brain death must be improved.
Topics: Brain Death; Humans; Organ Transplantation; Public Opinion; Television; Tissue Donors; Tissue and Organ Procurement
PubMed: 27642118
DOI: 10.1111/ajt.14016 -
The Yale Journal of Biology and Medicine Dec 2019In 2010, the American Academy of Neurology (AAN) published updated official guidelines for specific practices involved in the determination of death by neurologic... (Review)
Review
In 2010, the American Academy of Neurology (AAN) published updated official guidelines for specific practices involved in the determination of death by neurologic criteria for adult patients, otherwise known as brain death. Most states, however, do not have laws mandating the standard adoption of the AAN guidelines. The responsibilities for creating and implementing brain death determination policies thus falls on individual hospitals. As a result, significant variability in practice exists between hospitals and even between providers. This review highlights the ways in which and the extent to which adult brain death determination varies across the US, while also making the case that such persistent levels of heterogeneity call for improvements in standardizing training in brain death determination.
Topics: Adult; Brain Death; Hospitals; Humans; Physicians
PubMed: 31866786
DOI: No ID Found -
American Journal of Transplantation :... Jun 2017With 40 donors and more than 100 transplant procedures per million population in 2015, Spain holds a privileged position worldwide in providing transplant services to... (Review)
Review
With 40 donors and more than 100 transplant procedures per million population in 2015, Spain holds a privileged position worldwide in providing transplant services to its patient population. The Spanish success derives from a specific organizational approach to ensure the systematic identification of opportunities for organ donation and their transition to actual donation and to promote public support for the donation of organs after death. The Spanish results are to be highlighted in the context of the dramatic decline in the incidence of brain death and the changes in end-of-life care practices in the country since the beginning of the century. This prompted the system to conceive the 40 donors per million population plan, with three specific objectives: (i) promoting the identification and early referral of possible organ donors from outside of the intensive care unit to consider elective non-therapeutic intensive care and incorporate the option of organ donation into end-of-life care; (ii) facilitating the use of organs from expanded criteria and non-standard risk donors; and (iii) developing the framework for the practice of donation after circulatory death. This article describes the actions undertaken and their impact on donation and transplantation activities.
Topics: Brain Death; Humans; Organ Transplantation; Tissue Donors; Tissue and Organ Procurement
PubMed: 28066980
DOI: 10.1111/ajt.14104 -
Experimental and Clinical... Feb 2017The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea...
OBJECTIVES
The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution.
MATERIALS AND METHODS
We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old). We included people from universities, colleges, and the general public and asked questions on the circumstances of death, the conditions of conversations around organ donation, and reasons for acceptance or refusal of donation. The identical questionnaire, consisting of 8 questions, was administered twice: before and after a teaching session on brain death and organ procurement. The study was approved by our Ethical Review Committee and in accordance with the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from all participants.
RESULTS
We found that 72.1% understood brain death in the prequestionnaire and 88% understood brain death in the postquestionnaire, with 63.8% versus 68% accepting the concept of brain death, 50.6% versus 58.3% thinking that their religion is against brain death, 11.3% versus 11.3% carrying a donor card, 50.7% versus 58.9% wanting to carry a donor card, 46.4% versus 56.4% agreeing to give consent for organ donation if a relative was diagnosed with brain death, 28.3% versus 50% aware of the laws and regulations concerning brain death and organ donation and transplant in Jordan, and 35.4% versus 40% in agreement with the Presumed Consent Law, respectively.
CONCLUSIONS
In Jordan, along with legal requirements concerning brain death and organ donation and transplant, there is a lack of acceptance of organ donation after brain death, necessitating further work and activities to achieve self-sufficiency from donated organs.
Topics: Adolescent; Adult; Aged; Attitude to Death; Brain Death; Comprehension; Cultural Characteristics; Female; Government Regulation; Health Knowledge, Attitudes, Practice; Health Literacy; Health Policy; Humans; Informed Consent; Jordan; Male; Middle Aged; Religion and Medicine; Surveys and Questionnaires; Tissue Donors; Tissue and Organ Procurement; Young Adult
PubMed: 28260450
DOI: 10.6002/ect.mesot2016.O115 -
Medicine Sep 2022Precocity and assertiveness when diagnosing brain death are essential for identifying potential donors. To assess the knowledge of physicians about brain death and organ...
Precocity and assertiveness when diagnosing brain death are essential for identifying potential donors. To assess the knowledge of physicians about brain death and organ donation, cross-sectional web-based survey was carried out with physicians from different specialties. The knowledge about brain death and organ donation was assessed by a questionnaire with 12 multiple-choice or multiple-answer questions (possible range from 0 to 12). The nonparametric Mann-Whitney and Kruskal-Wallis tests were performed to verify the association between the physicians' knowledge and others variables. The project was approved by the Research Ethics Committee of the Hospital das Clínicas, Faculty of Medicine of Ribeirão Preto, University of São Paulo, under number 4.022.657, and all patients agreed to participate and provided free prior-informed consent. Three hundred sixty physicians were included in this study, most of them have postgraduate (55%) and 59.2% were intensive care physicians. The median of responses was 5 (obtained range from 0 to 10). The participants were classified in 2 groups: with satisfactory knowledge (scores above 5) or without satisfactory knowledge (scores equal/below 5). There was better performance among participants who: completed graduation between 6 and 10 years (P < .012); were intensive care physicians (P < .002); had participated in training courses (P < .001); and those who had worked in intensive care unit (ICU) from 6 to 10 years (P < .023); had performed over 10 brain death protocols (P < .001), and felt safe to talk to family members about brain death (P < .001). The results showed that the participants had low knowledge about diagnosis of brain death and organ donation protocols despite the majority working in ICUs. Be an intensive care physician, had large time experience in ICU, and had performed brain death protocols were associated with unsatisfactory knowledge concerning the subject.
Topics: Attitude of Health Personnel; Brain Death; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Humans; Intensive Care Units; Physicians; Surveys and Questionnaires; Tissue and Organ Procurement
PubMed: 36197182
DOI: 10.1097/MD.0000000000030793 -
Ugeskrift For Laeger Jun 2018Death can be pronounced on both circulatory and brain criteria. In both cases, irreversible loss of brain function is essential in understanding finale death, as... (Review)
Review
Death can be pronounced on both circulatory and brain criteria. In both cases, irreversible loss of brain function is essential in understanding finale death, as irreversible loss of breathing - a brainstem function - is mandatory. Brain function ceases irreversibly as a consequence of lack of blood supply to the brain, caused by circulatory arrest or by raised intracranial pressure. Brain function is central in death, which must be reflected in a future death criterion, stated in WHO´s new death criterion based on irreversible loss of capacity for consciousness and loss of brainstem function.
Topics: Brain Death; Brain Stem; Death; Humans
PubMed: 29938638
DOI: No ID Found -
British Journal of Anaesthesia Sep 2018
Topics: Adult; Brain; Brain Death; Cerebrovascular Circulation; Humans; Spectroscopy, Near-Infrared; Ultrasonography
PubMed: 30115246
DOI: 10.1016/j.bja.2018.05.058 -
The Journal of Thoracic and... Apr 2020
Topics: Brain Death; Heart Transplantation; Humans; Registries; Tissue Donors
PubMed: 31255347
DOI: 10.1016/j.jtcvs.2019.05.023 -
Journal of Religion and Health Aug 2016Brain death is a novel construct of death for the procurement of transplantable organs. Many authoritative Islamic organizations and governments have endorsed brain... (Review)
Review
Brain death is a novel construct of death for the procurement of transplantable organs. Many authoritative Islamic organizations and governments have endorsed brain death as true death for organ donation. Many commentators have reiterated the misconception that the Quranic text does not define death. We respond by clarifying: (1) the Quran does define death as biologic disintegration and clearly distinguishes it from the dying process, (2) brain death belongs scientifically within the spectrum of neurologic disorders of consciousness and should not be confused with death, and (3) religious and legal discord about brain death has grown in jurisdictions worldwide. We urge for public transparency and truthfulness about brain death and the accommodation and respect of religious objection to the determination of death by neurologic criteria.
Topics: Brain Death; Humans; Islam; Religion and Medicine; Tissue and Organ Procurement
PubMed: 27010462
DOI: 10.1007/s10943-016-0221-z