Background: Ancillary tests are indicated to diagnose death by neurological criteria whenever clinical neurological examination is unreliable, but their use is variable and subject to debate. Methods: Survey of Canadian intensivists providing care for potential organ donors. We included closed-ended questions and different clinical scenarios regarding the use of ancillary tests. Results: Among 550 identified intensivists, 249 completed the survey. Respondents indicated they would be comfortable diagnosing death based on neurological examination without ancillary tests in the following scenarios: movement in response to stimulation (48%), spontaneous peripheral movement (31%), inability to evaluate upper/lower extremity responses (34%) or both oculocephalic and oculo-caloric reflexes (17%), presence of high cervical spinal cord injury (16%) and within 24 hours of hypoxemic-ischemic brain injury (15%). Furthermore, 93% agreed that ancillary tests should always be conducted when a complete neurological examination is impossible, 89% if there remains possibility of residual sedative effect and 59% in suspected isolated brainstem death. Conclusions: Our findings suggest that Canadian intensivists have different perceptions on what constitutes a complete and reliable clinical neurological examination for determining death by neurologic criteria. Some self-reported practices also diverge from national recommendations. Further investigation and education are required to align and standardize medical practice across physicians and systems.

This article reviews the church and culture relationship developed in Gaudium et Spes and Lumen Gentium and proposes a Catholic account of modernity as a way in which the contemporary mission of the church in today's culture can be creatively and faithfully carried forward. After an initial outlining of the definitions of church and culture proposed by the Vatican documents, I then go on to position my proposal of a Catholic modernity in relation to some important current accounts of the church and culture relationship that tend towards a rejection of secular culture. I argue that Protestant accounts of modernity have dominated in philosophical and sociological theories and draw on my previous work on Max Weber to illustrate the significance of this for developing a Catholic account of modernity. I conclude by sketching some of the important issues which would need to be addressed in formulating a systematic account of a Catholic modernity.