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Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa.

Publication ,  Journal Article
Waweru-Siika, W; Clement, ME; Lukoko, L; Nadel, S; Rosoff, PM; Naanyu, V; Kussin, PS
Published in: Glob Public Health
May 2017

The concept of brain death (BD), defined as irreversible loss of function of the brain including the brainstem, is accepted in the medical literature and in legislative policy worldwide. However, in most of Sub-Saharan Africa (SSA) there are no legal guidelines regarding BD. Hypothetical scenarios based on our collective experience are presented which underscore the consequences of the absence of BD policies in resource-limited countries (RLCs). Barriers to the development of BD laws exist in an RLC such as Kenya. Cultural, ethnic, and religious diversity creates a complex perspective about death challenging the development of uniform guidelines for BD. The history of the medical legal process in the USA provides a potential way forward. Uniform guidelines for legislation at the state level included special consideration for ethnic or religious preferences in specific states. In SSA, medical and social consensus on the definition of BD is a prerequisite for the development BD legislation. Legislative policy will (1) limit prolonged and futile interventions; (2) mitigate the suffering of families; (3) standardise clinical practice; and (4) facilitate better allocation of scarce critical care resources in RLCs. There is a clear-cut need for these policies, and previous successful policies can serve to guide these efforts.

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Published In

Glob Public Health

DOI

EISSN

1744-1706

Publication Date

May 2017

Volume

12

Issue

5

Start / End Page

589 / 600

Location

England

Related Subject Headings

  • Public Health
  • Kenya
  • Humans
  • Health Policy
  • Guidelines as Topic
  • Decision Making
  • Brain Death
  • Africa South of the Sahara
  • 4407 Policy and administration
  • 4206 Public health
 

Citation

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Waweru-Siika, W., Clement, M. E., Lukoko, L., Nadel, S., Rosoff, P. M., Naanyu, V., & Kussin, P. S. (2017). Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa. Glob Public Health, 12(5), 589–600. https://doi.org/10.1080/17441692.2015.1094108
Waweru-Siika, Wangari, Meredith Edwards Clement, Lilian Lukoko, Simon Nadel, Philip M. Rosoff, Violet Naanyu, and Peter S. Kussin. “Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa.Glob Public Health 12, no. 5 (May 2017): 589–600. https://doi.org/10.1080/17441692.2015.1094108.
Waweru-Siika W, Clement ME, Lukoko L, Nadel S, Rosoff PM, Naanyu V, et al. Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa. Glob Public Health. 2017 May;12(5):589–600.
Waweru-Siika, Wangari, et al. “Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa.Glob Public Health, vol. 12, no. 5, May 2017, pp. 589–600. Pubmed, doi:10.1080/17441692.2015.1094108.
Waweru-Siika W, Clement ME, Lukoko L, Nadel S, Rosoff PM, Naanyu V, Kussin PS. Brain death determination: the imperative for policy and legal initiatives in Sub-Saharan Africa. Glob Public Health. 2017 May;12(5):589–600.

Published In

Glob Public Health

DOI

EISSN

1744-1706

Publication Date

May 2017

Volume

12

Issue

5

Start / End Page

589 / 600

Location

England

Related Subject Headings

  • Public Health
  • Kenya
  • Humans
  • Health Policy
  • Guidelines as Topic
  • Decision Making
  • Brain Death
  • Africa South of the Sahara
  • 4407 Policy and administration
  • 4206 Public health