`Brain Death' and Organ Retrieval
A Cross-sectional Survey of Knowledge and Concepts Among Health Professionals
- Stuart J. Youngner, MD;
- C. Seth Landefeld, MD;
- Claudia J. Coulton, PhD;
- Barbara W. Juknialis, MA;
- Mark Leary, MD
- From the Departments of Psychiatry (Drs Youngner and Leary) and Medicine (Drs Youngner and Landefeld and Ms Juknialis), the Center for Biomedical Ethics (Dr Youngner), the Clinical Analysis Project (Dr Landefeld and Ms Juknialis), and the Mandel School of Applied Social Sciences (Dr Coulton), Case Western Reserve University School of Medicine, Cleveland, Ohio; and University Hospitals of Cleveland (Ohio) (Dr Coulton).
Abstract
A sample of 195 physicians and nurses likely to be involved in organ procurement for transplantation was interviewed about knowledge, personal concepts, and attitudes concerning "brain death" and organ donation. Only 68 respondents (35%) correctly identified the legal and medical criteria for determining death. Personal concepts of death varied widely. Most respondents (58%) did not use a coherent concept of death consistently; others (19%) had a concept of death that was logically consistent with changing the whole-brain standard to classify anencephalics and patients in a persistent vegetative state as dead. The findings demonstrate confusion about correct criteria for determining death and differences in concepts of death that might prove troublesome to the transplantation enterprise. We conclude that health professionals should do more to resolve the clinical and conceptual issues in the definition and determination of death before policies concerning organ retrieval are changed.
(JAMA. 1989;261:2205-2210)
Footnotes
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Reprint requests to University Hospitals of Cleveland, 2040 Abington Rd, Cleveland, OH 44106 (Dr Youngner).
