Do people accept brain death as death? A study in Brazil.

BACKGROUND

Although the term brain death has been clinically and legally accepted as a death criterion, few data are published about public attitudes and beliefs concerning this topic.

OBJECTIVES

To examine public understanding of brain death and how the term brain death affects decisions about organ donation.

METHODS

Population-based cross-sectional study, with individuals aged 20 years or older in the urban area of Pelotas, State of Rio Grande do Sul, Brazil. The instrument used was a structured questionnaire, completed in individual interviews. chi2 and t test were used in the univariate and logistic regression in multivariate analysis.

RESULTS

Of 3159 participants, 80.1% would authorize organ donation from a relative who had previously declared a willingness to do so. However, when the words "brain death" were used as death, only 63% would authorize organ donation. When the subject had not been discussed, only a third of the participants would authorize the donation of a relative's organs.

CONCLUSIONS

When the term death was substituted with brain death, the willingness to donate decreased by 20%, suggesting that some individuals do not understand or accept the term brain death. Increasing comprehension about the concept of brain death and adopting educational strategies are essential to obtain higher rates of organ donation in developing countries.