File(s) under permanent embargo
Death, dying and donation: community perceptions of brain death and their relationship to decisions regarding withdrawal of vital organ support and organ donation
journal contribution
posted on 2020-10-01, 00:00 authored by George Skowronski, Michael J O'Leary, Christine Critchley, Lisa O'Reilly, Cynthia ForliniCynthia Forlini, Nancyz Ghinea, Linda Sheahan, Cameron Stewart, Ian KerridgeDespite brain death (BD) being established as a definition of death for over 50 years, the concept remains controversial. Little is known about public perception of death determination in decision‐making about withdrawal of organ support and organ donation (OD), and the importance of the ‘Dead Donor Rule’ (DDR). We examined perceptions about death in a BD patient and their relationship to decisions about withdrawal of vital organ support, OD and the DDR, using an online survey of 1017 Australian adults. A BD patient scenario was presented, followed by a series of questions. Statistically significant differences in responses were determined using repeated measures analyses of variance and t tests. Seven hundred and fourteen respondents (70.2%) agreed that a hypothetical BD patient was dead. Those disagreeing most commonly cited the presence of heartbeat and breathing. Seven hundred and seventy (75.7%) favoured removal of ‘life support’, including 136 (13.3%) who had not agreed the patient was dead. Support for OD was high, but most favoured organ removal only after heartbeat and breathing had ceased. Where OD was in keeping with the patient's known wishes, 464 (45.6%) agreed that organs could be removed even if this caused death. Forty‐one (20%) of those who had indicated they considered the patient was not dead agreed to organ removal even if it caused death. Australian public views on BD, withdrawal of ‘life support’ and OD are complex. Emphasis on prognosis and the impact of significant brain injury may be more appropriate in these situations, rather than focussing on death determination and upholding the DDR.
History
Journal
Internal Medicine JournalVolume
50Issue
10Pagination
1192 - 1201Publisher
Wiley-Blackwell Publishing AsiaLocation
Richmond, Vic.Publisher DOI
ISSN
1444-0903eISSN
1445-5994Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2020, Royal Australasian College of PhysiciansUsage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC