Cultural Considerations in the Declaration of Death by Neurologic Criteria in Asia

Despite a common Confucian foundation, Asia remains heterogeneous with regard to Westernization, especially as pertains to the declaration of death by neurologic criteria. A reliance on group harmony, traditional Chinese medicine concepts of death, and a reluctance to overturn the Confucian expectations of the elderly have hampered legislation and medical practice from embracing the concept of death by neurologic criteria. Where it does exist, such legislation subjugates death by neurologic criteria under the exclusive aegis of organ donation, a concept many Asians do not agree with. This chapter explores the current brain death diagnosis paradigm within East and Southeast Asia, emphasizing the cultural, legal, and societal underpinnings of the diverse countries within these areas that have stagnated efforts to rectify the problem. An analysis of the ineffectiveness of technological and economic assimilation on this issue is followed by a discussion of solutions unique to Asia that take into account the differing role of media and social media as compared to the West.