ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2021
Requests for somatic support after neurologic death determination: Canadian physician experiences.
Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 18 citations in OpenAlex.
- Themes in the Management of Pediatric Brain Death Contestation: Exploratory Qualitative Work From Multidisciplinary Health Professionals in the United States.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025Article
- New developments in guidelines for brain death/death by neurological criteria.Nature reviews. Neurology · 2024Review
- Death pluralism: a proposal.Philosophy, ethics, and humanities in medicine : PEHM · 2023Article
- Navigating disagreement and conflict in the context of a brain-based definition of death.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Review
- Consent for determination of death by neurologic criteria in Canada: an analysis of legal and ethical authorities, and consensus-based working group recommendations.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Trust and conflict in death determination-reflections on the legacy of Taquisha McKitty.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Rationale for revisions to the definition of death and criteria for its determination in Canada.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Organ donation in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document.Trauma surgery & acute care open · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeNeurologic determination of death (NDD) is legally accepted as death in Canada but remains susceptible to misunderstandings. In some cases, families request continued organ support after NDD. Conflicts can escalate to formal legal challenges, causing emotional, financial, and moral distress for all involved. We describe prevalence, characteristics, and common experiences with requests for continued organ support following NDD in Canada.
methodsMixed-methods design combining anonymous online survey with semi-structured interviews of Canadian critical care physicians (448 practitioners, adult and pediatric).
resultsOne hundred and six physicians responded to the survey and 12 participated in an interview. Fifty-two percent (55/106) of respondents had encountered a request for continued organ support after NDD within two years, 47% (26/55) of which involved threat of legal action. Requests for continued support following NDD ranged from appeals for time for family to gather before ventilator removal to disagreement with the concept of NDD. Common responses to requests included: consultation with an additional physician (54%), consultation with spiritual services (41%), and delay of one to three days for NDD acceptance (49%). Respondents with prior experience were less likely to recommend ancillary tests (P = 0.004) or consultation with bioethics services (P = 0.004). Qualitative analysis revealed perceptions that requests for continued organ support were driven by mistrust, tensions surrounding decision-making, and cultural differences rather than a lack of specific information about NDD.
conclusionsFamily requests for continued somatic support following NDD were encountered by half our sample of Canadian critical care physicians. Mitigation strategies require attention to the multifaceted social contexts surrounding these complex scenarios.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.