Attitudes toward Death and Brain Death among Turkey's Physicians: A Brief Research Report

Abstract

Brain death is a relatively new concept that became topical as a result of organ transplantation. Debate about this concept is currently continuing. This study was carried out to determine the attitudes of physicians toward brain death and to examine the effect of religion and education on the issue. Eight-hundred physicians who were randomly selected from 6 different cities in Turkey were questioned: 23.7% of physicians do not regard brain death as real death; 76.8% of relatives of these physicians' patients said that they have difficulty in understanding brain death. The reason for this is that brain death is an artificial concept created to meet the needs of organ transplantation. However, physicians are of the opinion that the attitudes toward death and brain death can be changed by education. In conclusion, the authors suggest that the brain death issue must be discussed by physicians, other professionals in Turkish society, and the general public so to reach a better concensus.

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

“…Several studies focused solely on the perspectives of physicians within specialties that directly related to organ donation (eg, intensive care units [ICUs], anesthesiology, neurosurgery). 53 , 68 , 70 , 72 , 75 , 81 , 96 Clinicians with greater exposure to BD determination such as those working in ICU and anesthesia were more comfortable and knowledgeable, 72 , 81 for example, intensivists were more knowledgeable than emergency and internal medicine physicians, 71 and ICU nurses more knowledgeable than non-ICU nurses. 87 , 95 University-affiliated physicians were also more knowledgeable than non–university-affiliated physicians.…”

“…However, despite an overall understanding and acceptance of the concept and application of BD in clinical practice, many HCPs also held contradictory beliefs that BD was not equivalent to real death, did not result in complete loss of brain function‚ or was not irreversible 53 , 69 , 70 , 76 - 78 , 80 , 82 , 83 , 88 …”

“…87,95 Universityaffiliated physicians were also more knowledgeable than non-university-affiliated physicians. 81 However, despite an overall understanding and acceptance of the concept and application of BD in clinical practice, many HCPs also held contradictory beliefs that BD was not equivalent to real death, did not result in complete loss of brain func-tion‚ or was not irreversible 53,69,70,[76][77][78]80,82,83,88 Several studies identified a lack of formal training on BD, whether within the academic training process or as continuing education. 73 The amount of training appeared to correlate with the role within the healthcare team, with attending staff reporting more formal training than nurses, and trainees reporting the least amount of formal training.…”

Muslim American physicians’ views on brain death: Findings from a national survey

“…[ 9 ] More significantly, a study in Turkey found that 38.2% of the Muslim physicians felt that patients who were diagnosed as “brain dead” should be kept alive for as long as possible. [ 10 ]…”

“…[9] More significantly, a study in Turkey found that 38.2% of the Muslim physicians felt that patients who were diagnosed as "brain dead" should be kept alive for as long as possible. [10] While some of this evidenced hesitation to declare "brain death" may be based in scientific and physiologic ambiguities, a physician's beliefs, culture, and religion may indeed play a role in their decision-making. Certainly, research documents how physicians' recommendations are influenced by cultural, personal, religious, and sociological factors.…”