Barriers to the Use of Neurologic Criteria to Declare Death in Africa

Author(s):  
Ariane Lewis ◽  
Andrew Kumpfbeck ◽  
Jordan Liebman ◽  
Sam D. Shemie ◽  
Gene Sung ◽  
...  

There are varying medical, legal, social, religious and philosophical perspectives about the distinction between life and death. Death can be declared using cardiopulmonary or neurologic criteria throughout much of the world. After solicitation of brain death/death by neurologic criteria (BD/DNC) protocols from contacts around the world, we found that the percentage of countries with BD/DNC protocols is much lower in Africa than other developing regions. We performed an informal review of the literature to identify barriers to declaration of BD/DNC in Africa. We found that there are numerous medical, legal, social and religious barriers to the creation of BD/DNC protocols in Africa including 1) limited number of healthcare facilities, critical care resources and clinicians with relevant expertise; 2) absence of a political and legal framework codifying death; and 3) cultural and religious perspectives that present ideological conflict with the idea of BD/DNC, in particular, and between traditional and Western medicine, in general. Because there are a number of unique barriers to the creation of BD/DNC protocols in Africa, it remains to be seen how the World Brain Death Project, which is intended to create minimum standards for BD/DNC around the world, will impact BD/DNC determination in Africa.

Neurology ◽  
2020 ◽  
Vol 95 (3) ◽  
pp. e299-e309 ◽  
Author(s):  
Ariane Lewis ◽  
Azza Bakkar ◽  
Elana Kreiger-Benson ◽  
Andrew Kumpfbeck ◽  
Jordan Liebman ◽  
...  

ObjectiveTo identify similarities and differences in protocols on determination of brain death/death by neurologic criteria (BD/DNC) around the world.MethodsWe collected and reviewed official national BD/DNC protocols from contacts around the world between January 2018 and April 2019.ResultsWe communicated with contacts in 136 countries and found that 83 (61% of countries with contacts identified, 42% of the world) had BD/DNC protocols, 78 of which were unique. Protocols addressed the following prerequisites and provided differing instructions: drug clearance (64, 82%), temperature (61, 78%), laboratory values (56, 72%), observation period (37, 47%), and blood pressure (34, 44%). Protocols did not consistently identify the same components for the clinical examination of brain death; 70 (90%) included coma, 70 (90%) included the pupillary reflex, 68 (87%) included the corneal reflex, 67 (86%) included the oculovestibular reflex, 64 (82%) included the gag reflex, 62 (79%) included the cough reflex, 58 (74%) included the oculocephalic reflex, 37 (47%) included noxious stimulation to the face, and 22 (28%) included noxious stimulation to the limbs. Apnea testing was mentioned in 71 (91%) protocols; there was variability in the technique and target across protocols. Ancillary testing was included as a requirement for all determinations of BD/DNC in 22 (28%) protocols.ConclusionsThere is considerable variability in BD/DNC determination protocols around the world. Medical standards for death should be the same everywhere. We recommend that a worldwide consensus be reached on the minimum standards for BD/DNC.


2018 ◽  
Vol 38 (05) ◽  
pp. 576-582 ◽  
Author(s):  
Ariane Lewis

AbstractAlthough the concept of death by neurologic criteria is accepted throughout much of the world and death can legally be determined by neurologic criteria throughout the United States, the process is fraught with contentious ethical and legal controversies. I explore historic and contemporary ethical and legal disputes about determination of death by neurologic criteria including the need for consent from patients' surrogates prior to determination of death, the role of religion in determination of death, management of objections to determination of death by neurologic criteria, the approach to patients who are dead by neurologic criteria but are pregnant, and gamete retrieval after determination of death.


In the modern digital age, the issues of using artificial intelligence and the field of development of intelligent technologies are extremely important and relevant. Over the past few years, there have been attempts of state regulation of artificial intelligence, both in Russia and in other countries of the world. Artificial intelligence poses new challenges to various areas of law: from patent to criminal law, from privacy to antitrust law. Among the current approaches, the most optimal is the creation of a separate legal regulation mechanism that creates a clear distinction between areas of responsibility of developers and users of systems with artificial intelligence and the technology itself. Today, the development of the legal framework for the existence of artificial intelligence can be conditionally divided into two approaches: the creation of a legal framework for the introduction of applied systems with artificial intelligence and stimulate their development; regulation of the sphere of creating artificial “super intelligence”, in particular, compliance of the developed technologies with generally recognized standards in the field of ethics and law. A separate area should be the introduction of uniform ethical principles for all developers and users of systems with artificial intelligence. The most optimal in this aspect is the approach implemented within the framework of the Asilomar principles. In these circumstances, the appeal to the problem of legal regulation of artificial intelligence is becoming more relevant than ever. This paper presents the results of a detailed analysis of existing approaches to the legal regulation of artificial intelligence.


Author(s):  
Roberto D. Hernández

This article addresses the meaning and significance of the “world revolution of 1968,” as well as the historiography of 1968. I critically interrogate how the production of a narrative about 1968 and the creation of ethnic studies, despite its world-historic significance, has tended to perpetuate a limiting, essentialized and static notion of “the student” as the primary actor and an inherent agent of change. Although students did play an enormous role in the events leading up to, through, and after 1968 in various parts of the world—and I in no way wish to diminish this fact—this article nonetheless argues that the now hegemonic narrative of a student-led revolt has also had a number of negative consequences, two of which will be the focus here. One problem is that the generation-driven models that situate 1968 as a revolt of the young students versus a presumably older generation, embodied by both their parents and the dominant institutions of the time, are in effect a sociosymbolic reproduction of modernity/coloniality’s logic or driving impulse and obsession with newness. Hence an a priori valuation is assigned to the new, embodied in this case by the student, at the expense of the presumably outmoded old. Secondly, this apparent essentializing of “the student” has entrapped ethnic studies scholars, and many of the period’s activists (some of whom had been students themselves), into said logic, thereby risking the foreclosure of a politics beyond (re)enchantment or even obsession with newness yet again.


2020 ◽  
Vol 1 (3) ◽  
pp. 206-210
Author(s):  
Ra`no Ergashova ◽  
◽  
Nilufar Yuldosheva

The creation, regulation, lexical and grammatical research and interpretation of the system of terms in the field of aviation in the world linguistics terminology system are one of the specific directions of terminology. Research on specific features is an important factor in ensuring the development of the industry. This article discusses morphological structure of aviation terms. The purpose of the article is to analyze the role of aviation terms in the morphology of the Uzbek language and its definition.


2020 ◽  
Author(s):  
Neide Célia Ferreira Barros

This book analyzes the criminal processes of homicides or attempted homicides of women in Goiânia during the period of 1970-1984. We observed the gender power relations in the capital of Goiás, a border region, a mixture of country life elements and discourses of modernity. Hence, through case reports of women who suffered attacks on their lives in a period of intense changes, such as the organization of feminist groups in Brazil and the world, political and economic repercussions of the construction of Brasília in Goiás and mass immigration to Goiânia, we have pursued to understand what it meant socially to "be a man" and "to be a woman" in this capital and what consequences were brought into their bodies, concerning life and death, protection and punishment.


2020 ◽  
Vol 3 (1) ◽  
pp. 156-160
Author(s):  
Khurshida Salimovna Safarova ◽  
Shakhnoza Islomovna Vosiyeva

Every great fiction book is a book that portrays the uniqueness of the universe and man, the difficulty of breaking that bond, or the weakening of its bond and the increase in human. The creation of such a book is beyond the reach of all creators, and not all works can illuminate the cultural, spiritual and moral status of any nation in the world by unraveling the underlying foundations of humanity. With the birth of Hoja Ahmad Yassawi's “Devoni Hikmat”, the Turkic nations were recognized as a nation with its own book of teaching, literally, the encyclopedia of enlightenment, truth and spirituality.


2020 ◽  
pp. 72-82
Author(s):  
I.L. Kapylou

The article describes the achievements and determines the prospects for the standardization of Belarusian onyms: it examines the problems associated with the establishment of official written forms of toponyms, the creation of normative onomastic reference books, the functioning of onyms in the situation of the state Belarusian-Russian bilingualism in Belarus, the transliteration of foreign names into the Belarusian language, the preparation of a legal framework and development of a program for proper names romanization.


GEOgraphia ◽  
2010 ◽  
Vol 10 (19) ◽  
pp. 103
Author(s):  
Alexandre Domingues Ribas ◽  
Antonio Carlos Vitte

Resumo: Há um relativo depauperamento no tocante ao nosso conhecimento a respeito da relação entre a filosofia kantiana e a constituição da geografia moderna e, conseqüentemente, científica. Esta relação, quando abordada, o é - vezes sem conta - de modo oblíquo ou tangencial, isto é, ela resta quase que exclusivamente confinada ao ato de noticiar que Kant ofereceu, por aproximadamente quatro décadas, cursos de Geografia Física em Königsberg, ou que ele foi o primeiro filósofo a inserir esta disciplina na Universidade, antes mesmo da criação da cátedra de Geografia em Berlim, em 1820, por Karl Ritter. Não ultrapassar a pueril divulgação deste ato em si mesma só nos faz jogar uma cortina sobre a ausência de um discernimento maior acerca do tributo de Kant àfundamentação epistêmica da geografia moderna e científica. Abrir umafrincha nesta cortina denota, necessariamente, elucidar o papel e o lugardo “Curso de Geografia Física” no corpus da filosofia transcendental kantiana. Assim sendo, partimos da conjectura de que a “Geografia Física” continuamente se mostrou, a Kant, como um conhecimento portador de um desmedido sentido filosófico, já que ela lhe denotava a própria possibilidade de empiricização de sua filosofia. Logo, a Geografia Física seria, para Kant, o embasamento empírico de suas reflexões filosóficas, pois ela lhe comunicava a empiricidade da invenção do mundo; ela lhe outorgava a construção metafísica da “superfície da Terra”. Destarte, da mesma maneira que a Geografia, em sua superfície geral, conferiu uma espécie de atributo científico à validação do empírico da Modernidade (desde os idos do século XVI), a Geografia Física apresentou-se como o sustentáculo empírico da reflexão filosófica kantiana acerca da “metafísica da natureza” e da “metafísica do mundo”.THE COURSE OF PHYSICAL GEOGRAPHY OF IMMANUEL KANT(1724-1804): CONTRIBUTION FOR THE GEOGRAPHICALSCIENCE HISTORY AND EPISTEMOLOGYAbstract: There is a relative weakness about our knowledge concerningKant philosophy and the constitution of modern geography and,consequently, scientific geography. That relation, whenever studied,happens – several times – in an oblique or tangential way, what means thatit lies almost exclusively confined in the act of notifying that Kant offered,for approximately four decades, “Physical Geography” courses inKonigsberg, or that he was the first philosopher teaching the subject at anyCollege, even before the creation of Geography chair in Berlin, in 1820, byKarl Ritter. Not overcoming the early spread of that act itself only made usthrow a curtain over the absence of a major understanding about Kant’stribute to epistemic justification of modern and scientific geography. Toopen a breach in this curtain indicates, necessarily, to lighten the role andplace of Physical Geography Course inside Kantian transcendentalphilosophy. So, we began from the conjecture that Physical Geography hasalways shown, by Kant, as a knowledge carrier of an unmeasuredphilosophic sense, once it showed the possibility of empiricization of hisphilosophy. Therefore, a Physical Geography would be, for Kant, theempirics basis of his philosophic thoughts, because it communicates theempiria of the world invention; it has made him to build metaphysically the“Earth’s surface”. In the same way, Geography, in its general surface, hasgiven a particular tribute to the empiric validation of Modernity (since the16th century), Physical Geography introduced itself as an empiric basis toKantian philosophical reflection about “nature’s metaphysics” and the“world metaphysics” as well.Keywords: History and Epistemology of Geography, Physical Geography,Cosmology, Kantian Transcendental Philosophy, Nature.


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