What does a diagnosis of brain death mean to family members approached about organ donation? A review of the literature

Background-What a diagnosis of brain stem death (the term used in the United Kingdom) or brain death (the term used in the United States) means to the family members of potential organ donors is an important issue to explore as biomedicine moves to expand the range of end-of-life technologies that, potentially, blur the demarcation between life and death. Objective-To provide some insights into how a diagnosis of brain stem death or brain death may be perceived by family members approached about organ donation. Methods-A review of the literature regarding organ donation was carried out. Results - Although most publications do not focus specifically oil the concept of brain death, those that do so made a valuable contribution, offering potential theoretical frameworks to aid our understanding of what the diagnosis of death by brain-based criteria means to family members of potential or-an donors. The diagnosis of brain death is intricately linked to the issue of organ donation and may influence family members' decision making. Also. the perception that death has occurred differs from one person to another. Conclusions-A sustained increase in the number of organs available for transplantation may never be achieved until the concepts of brain death, brain stern death. and now non-heart-beating death (1) arc debated more widely within society; (2) a greater degree of consensus is reached within health care; and (3) bereaved family members approached to donate the organs of their deceased relative have it better understanding of what these diagnoses mean. (Progress in Transplantation. 2008; 18:118-126)