Allied Muslim Healthcare Professional Perspectives on Death by Neurologic Criteria
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ETHICAL MATTERS
Allied Muslim Healthcare Professional Perspectives on Death by Neurologic Criteria Ariane Lewis1* , Elizabeth Kitamura2 and Aasim I. Padela3,4,5 © 2020 Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society
Abstract Background: We sought to evaluate how Muslim allied healthcare professionals view death by neurologic criteria (DNC). Methods: We recruited participants from two listservs of Muslim American health professionals to complete an online survey questionnaire. Survey items probed views on DNC and captured professional and religious characteristics. Comparative statistical analyses were performed after dichotomizing the sample based on religiosity, and Chi-squared, Fisher’s exact tests, likelihood ratios and the Kruskal–Wallis test were used to assess differences between the two cohorts. Results: There were 49 respondents (54%) in the less religious cohort and 42 (46%) in the more religious cohort. The majority of respondents (84%) believed that if the American Academy of Neurology guidelines are followed and a person is declared brain dead, they are truly dead; there was no difference on this view based on religiosity. Less than a quarter of respondents believed that outside of organ donation, mechanical ventilation, hydration, nutrition or medications should be continued after DNC; again, there was no difference based on religiosity of the sample. Importantly, half of all respondents believed families should be able to choose whether an evaluation for DNC is performed (40% of the less religious cohort and 60% of the more religious cohort, p = 0.09) and whether organ support is discontinued after DNC (49% of both cohorts, p = 1). Conclusions: Although the majority of allied Muslim healthcare professionals we surveyed believe DNC is death, half believe that families should be able to choose whether an evaluation for DNC is performed and whether organ support should be discontinued after DNC. This provides insight that can be helpful when making medical practice policy and addressing legal controversies surrounding DNC. Keywords: Brain death, End-of-life, Death, Islam, Religion, Law Introduction Death by neurologic criteria (DNC), commonly known as “brain death,” is the legal equivalent of death by cardiopulmonary criteria throughout the USA [1]. However, religious views on DNC vary [2, 3]. As a result, four states in the USA provide legal accommodation for religious objections to the use of neurologic criteria to declare *Correspondence: [email protected] 1 Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, 530 First Avenue HCC‑5A, New York, NY 10016, USA Full list of author information is available at the end of the article
death: in California and New York, reasonable efforts must be made to accommodate religious or moral objections to DNC; [4, 5] in Illinois, religious beliefs need to be taken into account when determining time of death; [6] and in New Jersey, DNC cannot be declar
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