Depictions of 'brain death' in the media: medical and ethical implications.

BACKGROUND Debates and controversies have shaped the understanding and the practices related to death determined by neurological criterion (DNC). Confusion about DNC in the public domain could undermine this notion. This confusion could further jeopardise confidence in rigorous death determination procedures, and raise questions about the integrity, sustainability, and legitimacy of modern organ donation practices. OBJECTIVE We examined the depictions of 'brain death' in major American and Canadian print media to gain insights into possible common sources of confusion about DNC and the relationship between expert and lay views on this crucial concept. METHODS We gathered 940 articles, available in electronic databases, published between 2005 and 2009 from high-circulation Canadian and American newspapers containing keywords 'brain dead' or 'brain death'. Articles were systematically examined for content (eg, definitions of brain death and criteria for determination of death) using the NVivo 8 software. RESULTS Our results showed problematic aspects in American and Canadian media, with some salient differences. DNC was used colloquially in 39% (N=366) of the articles and its medical meaning infrequently defined (2.7%; N=14 in the USA and 3.6%; N=15 in Canada). The neurological criterion for determination of death was mentioned in less than 10% of the articles, and life support in about 20% of the articles. Organ donation issues related to DNC were raised more often in Canadian articles than in American articles (33.5% vs 21.2%; p<0.0001). INTERPRETATION Further discussion is needed to develop innovative strategies to bridge media representations of DNC with experts' views in connection with organ donation practices.