Purpose Beliefs about the physiologic signs pinpointing the moment of death and about cadaver sentience may affect people's ideas about how to handle the cadaver. Because no research exists, we explored such beliefs according to two possible influences, ethnic group and gender.
Methods We conducted open-ended interviews with 26 Mexican American (MA), 18 European American (EA), and 14 African American (AA) men and women. A consensus-based content analysis identified themes. Because some subjects did not respond to every theme, percentages may add to under 100%.
Results Signs that subjects said pinpoint the moment of death differed among the six ethnic-gender groups. Most responses fell into three categories—stoppage of the heart, stoppage of the lungs, and cooling of the body. No one sign predominated. Responses for MA men and EA women ranged over all three categories: 14%, 7%, and 21%, respectively, for MA men; 27%, 45%, and 27%, respectively, for EA women. AA women mentioned only stoppage of the lungs (and just 43% did that). Yet the other three groups opined little: just 8-14% of MA women, EA men, and AA men mentioned any of the three signs above. Hence, the data do not characterize the opinions of those groups. Only two subjects mentioned brain criteria. Some subjects in all groups except MA women described out-of-body experiences, which subjects attributed to death (see the Table). Such experiences occurred with comas or cardiac arrests. All were visual; most were auditory. Subjects in all groups—including 29% or more of MA men, EA women, and AA men?believed the cadaver retains sentience, especially hearing or feeling.
Conclusions Ethnic group and gender influence beliefs about signs pinpointing the moment of death and about cadaver sentience. Those beliefs sometimes originate outside the scientific paradigm. When declaring death or discussing postmortem procedures such as organ donation or autopsy, health professionals may need to set aside the scientific paradigm and to work within people's unscientific beliefs.
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