Document Type

Article

Publication Date

9-22-2026

Comments

This article is the author’s final published version in Neurochirurgie, Volume 72, Issue 6, 2026, Article number 101879.

The published version is available at https://doi.org/10.1016/j.neuchi.2026.101879. Copyright © 2026 The Authors..

 

Abstract

BACKGROUND: Managing patients with non-survivable head trauma who do not meet brain death criteria presents significant ethical and clinical challenges. Decisions frequently fall to surrogates with limited guidance, particularly when organ donation status is unknown. This study assessed physician perspectives on communication, interventions, and institutional factors.

METHODS: We conducted a national survey of academic neurosurgery, trauma surgery, and neurocritical care programs. Items examined communication barriers, interventions by donor status, institutional support, and a dissonance measure for interventions viewed as inappropriate.

RESULTS: A total of 133 physicians responded. Top communication barriers were medical literacy, unclear patient values, and intrafamily conflict. Physicians offered more interventions when donor status was unknown than when patients were confirmed non donors. Lack of institutional support was associated with higher dissonance scores.

CONCLUSION: Care varies widely and is influenced by donor status and institutional culture, underscoring the need for clearer guidance and provider support.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

42772209

Language

English

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