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穆斯林医护专业人士对神经标准判定死亡的看法。

Allied Muslim Healthcare Professional Perspectives on Death by Neurologic Criteria.

机构信息

Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, 530 First Avenue HCC-5A, New York, NY, 10016, USA.

Department of Spiritual Care, NYU Langone Medical Center, 545 First Avenue GBH C-015, New York, NY, 10016, USA.

出版信息

Neurocrit Care. 2020 Oct;33(2):347-357. doi: 10.1007/s12028-020-01019-w.

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.

摘要

背景

我们旨在评估穆斯林医疗保健专业人员如何看待符合神经系统标准的死亡(DNC)。

方法

我们从两个穆斯林美国医疗保健专业人员的列表服务中招募参与者,以完成在线调查问卷调查。调查项目探讨了对 DNC 的看法,并捕获了专业和宗教特征。根据宗教信仰将样本分为两类后,进行了比较统计分析,并使用卡方检验、Fisher 精确检验、似然比和 Kruskal-Wallis 检验评估了两个队列之间的差异。

结果

在宗教信仰程度较低的队列中,有 49 名受访者(54%),在宗教信仰程度较高的队列中有 42 名受访者(46%)。大多数受访者(84%)认为,如果遵循美国神经病学学会指南并宣布一个人脑死亡,他们就真的死了;这种观点与宗教信仰无关。不到四分之一的受访者认为,在器官捐赠、机械通气、水合作用、营养或药物之外,在 DNC 后应继续进行机械通气、水合作用、营养或药物治疗;同样,这种观点也与样本的宗教信仰无关。重要的是,一半的受访者认为,家属应该能够选择是否进行 DNC 评估(宗教信仰程度较低的队列中有 40%,宗教信仰程度较高的队列中有 60%,p=0.09),以及是否在 DNC 后停止器官支持(两个队列均有 49%的人,p=1)。

结论

尽管我们调查的大多数穆斯林医疗保健专业人员认为 DNC 是死亡,但有一半人认为家属应该能够选择是否进行 DNC 评估以及是否在 DNC 后停止器官支持。这为制定医疗实践政策和解决围绕 DNC 的法律争议提供了有价值的见解。

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