'Brain death' and organ retrieval. A cross-sectional survey of knowledge and concepts among health professionals

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.

KIE: The authors surveyed 195 physicians and nurses likely to be involved in organ procurement for transplantation to determine knowledge, personal concepts, and attitudes concerning brain death and organ donation. Thirty-five percent of those surveyed correctly identified the legal and clinical criteria for determining death. There was a wide variation in personal concepts of death, with most respondents not using a coherent concept consistently. Others held a concept of death that was consistent with expanding the definition of brain death. Twenty-three percent of the respondents opposed required request laws. The authors conclude that their survey demonstrates confusion about determining death and differences in concepts of death that have implications for procurement of organs for transplantation. They recommend that health professionals do more to resolve the issues in the definition and determination of death.