Determination of death by neurologic criteria in Latin American and Caribbean countries

Lewis, Ariane; Kreiger-Benson, Elana; Kumpfbeck, Andrew; Liebman, Jordan; Bakkar, Azza; Shemie, Sam D.; Sung, Gene; Torrance, Sylvia; Greer, David M.

doi:10.1016/j.clineuro.2020.105953

Cited by 12 publications

(11 citation statements)

References 18 publications

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“…After communicating with contacts from 30/33 (91%) countries in the Latin America/Caribbean Group of the United Nations (26/30 (87%) of which the United Nations classify as developing), we found that 16 (53% of countries with contacts with whom we successfully communicated, 48% of countries in Latin America/the Caribbean) had BD/DNC protocols. 3,8 Similarly, after communicating with contacts from 37/57 (65%) countries in the United Nations Asia-Pacific Group plus Israel and Taiwan (34/37 (92%) of which the United Nations classify as developing), we found that 24 (65% of countries with contacts with whom we successfully communicated, 42% of countries in Asia/the Pacific) had BD/DNC protocols. 3,9…”

Section: Introductionmentioning

confidence: 65%

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Lewis

Kumpfbeck

Liebman

et al. 2021

Am J Hosp Palliat Care

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There are varying medical, legal, social, religious and philosophical perspectives about the distinction between life and death. Death can be declared using cardiopulmonary or neurologic criteria throughout much of the world. After solicitation of brain death/death by neurologic criteria (BD/DNC) protocols from contacts around the world, we found that the percentage of countries with BD/DNC protocols is much lower in Africa than other developing regions. We performed an informal review of the literature to identify barriers to declaration of BD/DNC in Africa. We found that there are numerous medical, legal, social and religious barriers to the creation of BD/DNC protocols in Africa including 1) limited number of healthcare facilities, critical care resources and clinicians with relevant expertise; 2) absence of a political and legal framework codifying death; and 3) cultural and religious perspectives that present ideological conflict with the idea of BD/DNC, in particular, and between traditional and Western medicine, in general. Because there are a number of unique barriers to the creation of BD/DNC protocols in Africa, it remains to be seen how the World Brain Death Project, which is intended to create minimum standards for BD/DNC around the world, will impact BD/DNC determination in Africa.

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Section: Introductionmentioning

confidence: 65%

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Lewis

Kumpfbeck

Liebman

et al. 2021

Am J Hosp Palliat Care

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“…An interesting finding was that the few African countries that have BD/ DNC protocols are dissimilar compared with other developing countries. The authors also affirmed that, compared with Africa, the proportion of countries with BD/DNC protocols in Latin America/the Caribbean and Asia/the Pacific is similar to that of the world in general [1,2,[5][6][7][8][9][10][11][12][13][14][15][16].…”

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confidence: 75%

“…The World Brain Death Project addresses discrepancies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis [2,3,[4][5][6][7][8][9][10][11][12][13][14][15][16]. Now, Lewis et al particularized analysis of brain death/death by neurologic criteria (BD/DNC) protocols in Africa and found that the percentage of countries with BD/DNC protocols is much lower in Africa than in other developing regions.…”

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confidence: 99%

Hitches to establish BD/DNC protocols to declare death in Africa

Machado¹

2021

Frontiers Drug Chemistry Clinical Res

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The World Brain Death Project addresses discrepancies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis. The World Brain Death Project published an outstanding paper formulating a consensus statement of recommendations on the determination of brain death/ death by neurologic criteria (BD/DNC). Now, Lewis et al particularized analysis of brain death/death by neurologic criteria (BD/DNC) protocols in Africa and found that the percentage of countries with BD/DNC protocols is much lower in Africa than in other developing regions. This is the largest assessment up to the present time about the prevalence of BD/DNC protocols in that continent. The authors also affirmed that, compared with Africa, the proportion of countries with BD/DNC protocols in Latin America/the Caribbean and Asia/the Pacific is similar to that of the world in general. In Africa, hundreds of religions are recognized. In Cuba, the Yoruba religion is very common [1]. Santería, was developed in Cuba and then spread throughout Latin America and the United States. Santería was brought to Cuba by people of the Yoruban nations of West Africa (mainly from the actual territory of Nigeria), who were enslaved in great numbers in the first decades of the 19th century. It arose through a process of syncretism between the traditional Yoruba religion of West Africa, the Roman Catholic form of Christianity, and Spiritism. Curiously, although in Cuba, Santeria, and Christian religions are common, contrary to Africa, most people accept BD/DNC and organ donation. It is also important to consider many African countries are lacking primary and essential medical services, which makes more difficult the establishment of BD/DNC and organ donation protocols.

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“… 68 , 75 The determination protocols and the need for ancillary testing vary between and within countries, leading to a lack of consistency for the BD diagnosis worldwide. 97 , 98 …”

Section: Resultsmentioning

confidence: 99%

Healthcare Professionals’ Understandings of the Definition and Determination of Death: A Scoping Review

Zheng

Sutherland

Hornby

et al. 2022

Transplantation Direct

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Background. During the 1950s, advances in critical care, and organ transplantation altered the relationship between organ failure and death. There has since been a shift away from traditional cardiocirculatory based to brain-based criteria of death, with resulting academic controversy, despite the practice being largely accepted worldwide. Our objective is to develop a comprehensive description of the current understandings of healthcare professionals regarding the meaning, definition, and determination of death. Methods. Online databases were used to identify papers published from 2003 to 2020. Additional sources were searched for conference proceedings and theses. Two reviewers screened papers using predefined inclusion and exclusion criteria. Complementary searches and review of reference lists complemented the final study selection. A data extraction instrument was developed to iteratively chart the results of the review. A qualitative approach was conducted to thematically analyze the data. Results. Seven thousand four hundred twenty-eight references were identified. In total, 75 papers met the inclusion criteria. Fourteen additional papers were added from complementary searches. Most were narratives (35%), quantitative investigations (21%), and reviews (18%). Identified themes included: (1) the historical evolution of brain death (BD), (2) persistent controversies about BD and death determination, (3) wide variability in healthcare professionals’ knowledge and attitudes, (4) critical need for BD determination revision. Conclusions. We concluded that although BD is widely accepted, there exists variation in healthcare providers’ understanding of its conceptual basis. Death determination remains a divisive issue among scholars. This review identified a need for increased opportunities for formal training on BD among healthcare providers.

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Determination of death by neurologic criteria in Latin American and Caribbean countries

Cited by 12 publications

References 18 publications

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Hitches to establish BD/DNC protocols to declare death in Africa

Healthcare Professionals’ Understandings of the Definition and Determination of Death: A Scoping Review

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