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


Journal

Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 09 11 2021
revised: 06 02 2022
accepted: 08 02 2022
entrez: 4 4 2022
pubmed: 5 4 2022
medline: 5 4 2022
Statut: epublish

Résumé

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. 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. 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. 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.

Sections du résumé

Background UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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.

Identifiants

pubmed: 35372677
doi: 10.1097/TXD.0000000000001309
pmc: PMC8963853
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

e1309

Informations de copyright

Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

L.H. is a paid consultant for Canadian Blood Services. The remaining authors declare no conflicts of interest.

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Auteurs

Katina Zheng (K)

Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Canadian Blood Services, Ottawa, ON, Canada.

Stephanie Sutherland (S)

Canadian Blood Services, Ottawa, ON, Canada.
Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.

Laura Hornby (L)

Canadian Blood Services, Ottawa, ON, Canada.
Division of Pediatric Critical Care, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.

Lindsay Wilson (L)

Canadian Blood Services, Ottawa, ON, Canada.

Sam D Shemie (SD)

Canadian Blood Services, Ottawa, ON, Canada.
Division of Critical Care, Montreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada.

Aimee J Sarti (AJ)

Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.

Classifications MeSH