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Dear participants,

We are students at the Illinois and Mathematics and Science Academy
, investigating the perceptions relating to end of life issues,
especially those related to brain death.

The purpose of this study is to identify the source of varied
comprehension about the prognosis of patients with devastating brain
damage in society. Over the past 40 years, the medical definitions
relating to of death have changed significantly. At the same time, it
is thought that the gap between accepted medical practice and public
understanding has widened. This basis is the result of physician
experiences with patient families as well as representatives of organ
procurement organizations

While conformity in the medical community of what constitutes death
is critical in diagnosing brain death, the public perception of what
constitutes brain death is critical in understanding death and
accepting that death has occurred, and will prove beneficial to medical
practitioners, patients, and families alike.

This study explores perceptions regarding brain death and its
significance in identifying that death has occurred. To do this, we ask
that you complete a short survey, answering questions without the use
of any resources, and basing your responses on your perceptions and NOT what you consider to be societal or legal views.

Your voluntary response to this request constitutes your informed
consent to your participation in this activity. You are not required to
participate. If you decide not to participate, your decision will not
affect your current or future relations with the research team, the
Illinois Mathematics and Science Academy , or any other involved
parties.

The questionnaire will take approximately 15 minutes to complete
will be submitted electronically. If you provide your email address
(which will be used for only this purpose, and will not be used to
identify responses, and/or shared with third parties), we will share
the results of the study upon completion

If you have experienced a recent death in your family, have had
experience with brain death, or if you just find the activity
unsettling or distressing you do not need to complete the activity. If
you at any time wish to discontinue the activity, please speak with one
of the project staff on hand or please call David Qasem at 630-240-2716

This activity has NOT yet received IRB approval, as it is being piloted as a survey instrument.

Thank you for your valuable contribution to this research.

Please note that by providing your initials and date of birth, you
are providing a “virtual signature” that indicates that you have read
all of the information within this consent form and that all of your
questions have been adequately answered. Furthermore, this signature
indicates your willingness to participate in this study.