All agree that it is mandatory to provide sound evidence that the

All agree that it is mandatory to provide sound evidence that the brain is irreversibly dead. While, in general, the public accepts the medical judgment in the definition of death, there are occasional cases where a family does not agree with the diagnosis of brain death by the medical team. This may result from the personal beliefs, emotions, and distrust of the family Inhibitors,research,lifescience,medical in the medical system. Often, in critical moments of imminent death, several families, not necessarily religious, seek advice from religious authorities and submit to their judgments. It is therefore clear that trust between the medical community Inhibitors,research,lifescience,medical and the public,

through its religious leaders, is a critical element in this complex process of accepting brain death and agreeing to organ donation when appropriate. A recent law on the definition of brain death was passed in Israel in 2008 and has been in effect since the middle of 2009.12 The law involves medical, selleck compound ethical, and religious aspects of death and defines strict rules

as to how and by whom the diagnosis of brain Inhibitors,research,lifescience,medical death should be confirmed. The law mandates the use of objective diagnostic tests such as transcranial Doppler, brain angiography, and single photon emission computed tomography (SPECT) imaging and also sets an uncompromised requirement for the apnea test despite many pitfalls that may exist with this study.13 Inhibitors,research,lifescience,medical The physicians are required to provide evidence by mandatory ancillary tests of no brain activity,

no blood-flow to the brain, and no respiratory drive. One of the major reasons for the new law was to ensure standardization of the procedure of brain death diagnosis across all hospitals in Israel. Therefore, the law allows very limited clinical judgment in brain death diagnosis and mandates confirmatory Inhibitors,research,lifescience,medical ancillary tests. It was hypothesized that the new law, by providing standardization of brain death criteria which are not open to interpretation, would relieve the tension within the community with respect to the definition Unoprostone of brain death and would increase the trust between the medical community and the general public, including the religious sections. It was therefore suggested that the law would increase the tendency of the public to consent to organ donation and would alleviate the shortage of organs. As the law was implemented in the middle of 2009, comparing transplantation data during 2010 to parallel data during 2008 provides a reasonable estimate for the immediate effect of the law (Table 1). Table 1 Comparison of transplantations before and after the “Law for Brain and Respiratory Death” that was implemented during 2009.

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