A Disclosure About Death Disclosure: Variability in Circulatory Death Determination


  • Christopher P. Robinson, D.O., M.S.
  • Suzanne L. Hunt, M.S.
  • Gary S. Gronseth, M.D.
  • Sara Hocker, M.D.
  • Eelco F.M. Wijdiicks, M.D., Ph.D.
  • Alejandro A. Rabinstein, M.D.
  • Sherri A. Braksick, M.D.




Introduction. Circulatory-respiratory death declaration is a common duty of physicians, but little is known about the amount of education and physician practice patterns in completing this examination.

Methods. We conducted an online survey of physicians evaluating the rate of formal training and specific examination techniques used in the pronouncement of circulatory-respiratory death. Data, including level of practice, training received in formal death declaration, and examination components were collected.

Results. Respondents were attending physicians (52.4%), residents (30.2%), fellows (10.7%), and interns (6.7%). The majority of respondents indicated they had received no formal training in death pronouncement, however, most reported self-perceived competence. When comparing examination components used by our cohort, 95 different examination combinations were used for death pronouncement.

Conclusions. Formal training in death pronouncement is uncommon and clinical practice varies. Implementation of formal training and standardization of the examination are necessary to improve physician competence and reliability in death declarations.






Original Research