Are you an inpatient hospital chaplain?
Yes
No
While working as a hospital chaplain, have you ever been involved in a case in which a patient was undergoing evaluation for brain death determination?
Yes
No
While working as a hospital chaplain, have you ever been involved in a case in which a family objected to performance of a brain death determination or discontinuation of organ support after brain death based on their religious beliefs?
Yes
No
Please specify the religion(s) of patients you've been involved with in which a family objected to performance of a brain death determination or discontinuation of organ support after brain death based on their religious beliefs
In the most recent case you were involved in that involved an objection to performance of a brain death determination or discontinuation of organ support based on their religious beliefs, what was the outcome of the objection? Please check all that apply.
On a scale of 1-10, with 1 being the least comfortable and 10 being the most comfortable, how comfortable were you with the way the hospital handled the most recent case you were involved in that involved an objection to performance of a brain death determination or discontinuation of organ support?
On a scale of 1-10, with 1 being the least comfortable and 10 being the most comfortable, how comfortable were you with the outcome of the most recent case you were involved in that involved an objection to performance of a brain death determination or discontinuation of organ support?
Based on your understanding of brain death, which of the following is required to make a declaration of brain death? Please check all that apply.
Are you aware that brain death is considered to be the medical and legal equivalent of cardiopulmonary death throughout the United States?
Yes
No
Are you aware that outside of the setting of organ donation, organ support (artificial support including mechanical ventilation, nutrition, hydration, blood pressure support) is routinely discontinued when a declaration of brain death is made?
Yes
No
Are you aware that some states in the United States legally require hospitals to provide accommodation to individuals who report religious objections to the use of neurologic criteria to declare death?
Yes
No
Do you believe that every state in the United States should legally require hospitals to provide accommodation to individuals who report religious objections to the use of neurologic criteria to declare death?
Yes
No
Unsure
Do you believe that a person's family should be able to choose whether or not an assessment for determination of brain death is performed?
Yes
No
Unsure
Why do you believe a person's family should/should not be able to choose whether or not an assessment for determination of brain death is performed?
If a brain death determination is performed in accordance with the American Academy of Neurology guidelines and a person is found to be brain dead, do you believe that this person can recover?
Yes
No
Unsure
If a brain death determination is performed in accordance with the American Academy of Neurology guidelines and a person is found to be brain dead, do you believe that this person is dead?
Yes
No
Unsure
Why do/don't you believe that a person who meets the American Academy of Neurology's criteria for brain death is dead?
Do you think that all religious Christians would agree with your opinion about whether or not a person who is brain dead in accordance with the American Academy of Neurology guidelines is dead?
Yes
No
Unsure
Do you think that all spiritual leaders would agree with your opinion about whether or not a person who is brain dead in accordance with the American Academy of Neurology guidelines is dead?
Yes
No
Unsure
Do you believe that a person who is brain dead can have organs removed for donation?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that a person's family should be able to choose whether or not organ support (artificial support including mechanical ventilation, nutrition, hydration, blood pressure support) is discontinued after declaration of brain death?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that mechanical ventilation should be continued after a declaration of brain death?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that hydration should be continued after a declaration of brain death is made?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that nutrition should be continued after a declaration of brain death is made?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that medications should be continued after a declaration of brain death is made?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that additional therapies (such as antibiotics, blood pressure support) should be started if clinically warranted after brain death?
Yes
No
Unsure
Outside of the setting of organ donation, do you believe that cardiopulmonary resuscitation (CPR) should be performed when a brain dead person's heart stops?
Yes
No
Unsure
Which of the following organizations do you belong to?
How long have you been a hospital chaplain?
0-5 years
6-10 years
11-15 years
16-20 years
21 or more years
Are you a board certified chaplain?
Yes
No
How would you describe your hospital environment?
University hospital
Government hospital
Other
How many beds are in your hospital?
Less than 200
201-400
401-600
601 or more
Where do you live (please provide the state you live in if you live in the USA, or the country you live in if you live outside of the USA)?
Under 30
30-40
41-50
51-60
61-70
71-80
Over 81
What religion do you identify with?
