Knowledge, acceptance and perception towards brainstem death among medical students in Hong Kong: a questionnaire survey on brainstem death

Figures & data

Table

Practice points
•General knowledge on BSD of medical students in Hong Kong is inadequate.
•Persistent vegetative state is often confused with BSD.
•Higher level of knowledge on BSD is a positive factor in agreeing to withdrawal of life-support.
•Perception towards the ‘incentive’ underlying the diagnosis of BSD does not negatively affect the decision on the withdrawal of life-support.

Table 1.  Demographic data of the subjects

Demographic factors	N (%)
Gender (n = 126)
Male	65 (51.6)
Female	60 (47.6)
Unknown	1 (0.8)
Year of study (n = 126)
Pre-clinical years	68 (54.0)
Clinical years	58 (46.0)
Religion (n = 126)
Without religion	76 (60.3)
With religion	49 (38.9)^a
Unknown	1 (0.8)

^aAmong the subjects with a religion, 83.7% of them were Christians, 16.3% included Catholic, Buddhism and others.

Table 2.  The 10 questions and the subjects’ responses

In a person diagnosed with brainstem death	Correct answer	No. of subjects with answers correct (%)
May he/she have feelings or thinking? (n = 125)	No	72 (57.6)
May he/she be aware of the surroundings? (n = 125)	No	78 (62.4)
May he/she shed tears? (n = 125)	Yes	35 (28.0)
May he/she move his/her fingers? (n = 124)	No	73 (58.9)
Can he/she breathe on his/her own? (n = 125)	No	104 (83.2)
Can he/she have a beating heart? (n = 125)	Yes	64 (51.2)
Can he/she swallow? (n = 125)	No	111 (88.8)
Can he/she urinate or defecate? (n = 125)	Yes	24 (19.2)
Can he/she be in the same state for weeks if we provide life-support? (n = 124)	Yes	83 (66.9)
Is he/she equivalent to be in persistent vegetative state? (n = 125)	No	61 (48.8)

Figure 1. Decisions for a family member/most-loved one amongst subjects who agreed to withdrawal of life-support from themselves.

Figure 2. Decisions for a stranger amongst subjects who agreed to withdrawal of life-support from themselves.

Table 3.  Decisions on withdrawing life-support from the three hypothetical groups of patients

Decision on withdrawal of life-support	No. of subjects (%)
From yourself (n = 124)
Agree	79 (63.7)
Not agree	20 (16.1)
Not sure	25 (20.2)
From your family member/most-loved one (n = 124)
Agree	58 (46.8)
Not agree	35 (28.2)
Not sure	31 (25.0)
From a stranger (n = 124)
Agree	65 (52.4)
Not agree	27 (21.8)
Not sure	32 (25.8)

Table 4.  Knowledge and the decision to withdraw life-support treatment

Decision on withdrawal of life-support from	Mean score of subjects who agreed	Mean score of subjects who did not agree	Mean difference	95% CI	p
Themselves	6.30	5.35	0.954	0.036–1.872	0.042
Their family member/most-loved one	6.33	5.63	0.699	−0.124–1.522	0.095
A stranger	6.37	5.70	0.666	−0.155–1.486	0.111

Table 5.  Relationship between the subjects’ perception of BSD and the withdrawal of life-support treatment: (a); (b); (c)

Subjects thought that doctors diagnosing BSD to		% of subjects who agreed WDLS	% of subjects who did not agree WDLS	p-value
(a) Life-support withdrawal from the subjects themselves
Save resources:	Yes	93.3	6.7	0.198
	No	79.2	20.8
Procure organs:	Yes	100	0	0.019
	No	76.4	23.6
(b) Life-support withdrawal from the subjects’ family member/most-loved one
Save resources:	Yes	57.1	42.9	0.545
	No	65.7	34.3
Procure organs:	Yes	72.2	27.8	0.388
	No	61.2	38.8
(c) Life-support withdrawal from a stranger
Save resources:	Yes	80.0	20.0	0.388
	No	71.6	28.4
Procure organs:	Yes	83.3	16.7	0.250
	No	69.7	30.3