Author(s): Santasha Dhoot

Date Authored: September 19, 2017

Image of an MRI brain scan
Photo by Penn State (cc license).

This literature review examines findings from 10 research articles in peer-reviewed journals about cultural perceptions around brain death for refugee/immigrant communities.

During complicated end-of–life conversations, it is important for providers to understand how to best relate to their patients. With the technological advancements of life sustaining systems, brain death has been defined as a newer indicator of death. But brain death is often misunderstood and can be a particularly difficult topic to broach with refugee and immigrant communities. As the concept of brain death becomes enshrined in Western clinical practice, there is a need for providers to understand the perceptions and knowledge around the definition of death and brain death for people of different cultures and religious backgrounds.

What are cultural perceptions and knowledge around the definition of death and brain death?

The purpose of this literature review is to explore the cultural understanding of death and brain death among refugee and immigrant communities.

The literature review itself is available in PDF table format (and in sidebar).


Bowman, K., & Richard, S. (2003). Culture, brain death, and transplantation. Progress in Transplantation, 13(3), 211-5

Bülow, H., Sprung, C., Reinhart, L., Prayag, K., Du, S., Armaganidis, B., Levy, F. (2008). The world’s major religions’ points of view on end-of-life decisions in the intensive care unit. Intensive Care Medicine, 34(3), 423-430.

Hedayat, K. (2006). When the spirit leaves: Childhood death, grieving, and bereavement in Islam. Journal of Palliative Medicine, 9(6), 1282-1291.

Klessig, J. (1992). The effect of values and culture on life-support decisions, In Cross-cultural Medicine-A Decade Later [Special Issue]. West J Med, Sep; 157:316-322

Mcconnell, J. (1999). The ambiguity about death in Japan: An ethical implication for organ procurement. Journal of Medical Ethics, 25(4), 322.

Miller, A.C., Ziad-Miller, A., Elamin, E.M. (2014). Brain Death and Islam. Chest. 146(4):1092-1101. doi:10.1378/chest.14-0130.

Padela, A., Arozullah, A., & Moosa, E. (2015). Brain Death in Islamic Ethico-Legal Deliberation: Challenges for Applied Islamic bioethics. Bioethics, 29(1), 56.

Siminoff, L., Burant, C. & Youngner, S.J. (2004). Death and organ procurement: Public beliefs and attitudes. Social Science & Medicine, 59(11), 2325-2334.

Wijdicks, E. (2002). Brain death worldwide – Accepted fact but no global consensus in diagnostic criteria. Neurology, 58(1), 20-25.

Yang, Q., & Miller, G. (2015). East–West Differences in Perception of Brain Death. Journal of Bioethical Inquiry, 12(2), 211-225.History