The presence of family during brain stem death testing.
Prior to 1959, cardiac and respiratory cessation was universally and unambiguously accepted as confirming the death of a person [M. Morioka, J. Clin. Nurs. 10 (2001) 132; Reconsidering brain death: a lesson from Japan's fifteen years of experience, 2001, http://proquest.umi.com/pqdweb]. However, with the rapid pace of modern technology and resuscitation techniques, the boundaries between life and death have become blurred [J. Bothamley, Organ donation: brain stem death, 2000, http://proquest.umi.com/pqdweb; Re-examining death: against a higher brain criterion, 1999, http://proquest.umi.com/pqdweb]. As a result, a redefinition of death, "brain death" has emerged [M. Brazier, Medicine, Patients and the Law, New ed., Penquin Books, London, 1992]. Most families faced with the brain stem death of a relative find the concept difficult to understand and have trouble in accepting that their relative is actually dead. In Part One of this two part series, the needs of families who are facing the brain stem death of a family member will be examined and explanations offered as to why families find the concept difficult to grasp. In addition, it will also advocate that family members are given the choice to be or not to be present during brain stem death testing. It is suggested that the presence of family members during brain stem death testing not only helps families to accept this concept of death but also promotes the grieving process. In Part Two, the barriers that inhibit family involvement and presence will be explored and methods for involving family proposed.
Doran
Majella
M
Altnagelvin Hospital, Glenshane Road, Londonderry, Northern Ireland, UK. jackie.doran@btopenworld.com
D001293:Attitude to Death; D001294:Attitude to Health; D001926:Brain Death / Q000175:diagnosis*; D001933:Brain Stem; D016638:Critical Illness / Q000523:psychology; D005190:Family / Q000523:psychology*; D006117:Grief; D006339:Heart Rate; D006801:Humans; D020380:Needs Assessment / Q000941:ethics / Q000458:organization & administration; D010362:Patients' Rooms; D028723:Personhood; D012944:Social Support; D009927:Tissue and Organ Procurement / Q000941:ethics / Q000458:organization & administration; D014789:Visitors to Patients / Q000193:education / Q000523:psychology*