The Presence of Family Members During Brainstem Testing: An Ethical Dilemma.
Natalie L McEvoy, Pierce Geoghegan, Sophia Downey and 4 others
PMID 40958442WHAT IT FOUND
Family presence during brainstem testing is inconsistently offered.
Witnessing may help families understand brain death, but some evidence associates it with distress and a lower organ donation consent rate. Nurses should support an informed family choice and plan staffing for emotional support.
Key findings
01Family presence during brainstem testing is inconsistently offered: one survey found 44% (n=21) of 48 ICUs invited families, and another UK survey found 32% of doctors and 42% of nurses had experienced relatives' presence.
02Witnessing brainstem testing may increase family understanding, but some relatives report greater distress and evidence associates presence with a lower organ donation consent rate.
03Nurses may be needed to support families during testing, but assigning extra support can strain already short-staffed ICUs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The patient story describes a single person, so it does not show that family presence helps or harms others. This is an ethical review, not a systematic review or trial, so the authors' interpretation of the literature may not be complete. The cited evidence points in different directions: some reports suggest better understanding, while others report distress or an association with lower organ donation consent. There is no tested staffing model, so advice about assigning a nurse to support families is practical but not proven. Guidance varies by country and institution, so local policy may differ.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that family presence during brainstem testing should be offered to all families or avoided because it improves or harms outcomes. The evidence is mixed, comes from a single case and narrative review, and does not establish cause.