Determination of death by neurologic criteria in Latin American and Caribbean countries.

OBJECTIVES:We sought to (1) identify the countries in the Latin America/Caribbean Group of the United Nations (GRULAC) that have protocols for brain death/death by neurologic criteria (BD/DNC) and (2) review the similarities and differences between these protocols. MATERIALS AND METHODS:Between January 2018 and April 2019, we obtained and reviewed BD/DNC protocols from countries in GRULAC. RESULTS:We communicated with contacts in 30/33 countries in GRULAC (91 % of countries) and found that 16 (53 % of countries with contacts, 48 % of Latin American/Caribbean countries) had BD/DNC protocols. Of the 13 protocols that provided a definition of death, 10 (77 %) referred to whole brain death. The number of exams/examiners, prerequisites for BD/DNC, and descriptions of the clinical assessment and apnea test were inconsistent among protocols. Although Brazil and Panama required an ancillary test, the indications for ancillary testing, and the types of accepted ancillary tests, varied by country. CONCLUSION:BD/DNC determination protocols in the countries in GRULAC are inconsistent. Acknowledging the fact that there are diverse cultural, legal and religious perspectives on death, and human and technological resources differ by region, we recommend that attempts be made to harmonize protocols on BD/DNC both regionally and worldwide.