Join the network
If you are a researcher, clinician, or institution interested in law, medicine, and culture at the end of life, we invite you to connect with us and take part in shaping this European initiative.
Understanding death in Europe: law, medicine, culture
EUROPEAN NETWORK FOR DEATH DETERMINATION,
KNOWLEDGE, AND END-OF-LIFE PRACTICES
What is death in Europe today?
In contemporary Europe, death is not organised as a single moment. Its recognition and consequences take shape across the boundaries of law, medicine, institutions, and social life.
Our focus is on how death is determined, communicated, and made actionable in hospitals and intensive care units – places where medical knowledge, law, institutional responsibility, family experience, and irreversible decisions meet. We examine how different actors reach sufficient certainty to act, where gaps in knowledge and understanding emerge, and how the consequences of these processes continue beyond the hospital through family memory, trust, doubt, ritual, and social continuity.
Why this matters
European countries share medical knowledge and professional guidance, yet death determination and end-of-life care operate within very different legal, institutional, and cultural environments. Similar clinical situations can therefore enter different sequences of decision-making, documentation, communication, and responsibility.
Europe already has strong research and professional networks around ICU ethics, palliative care, and transplantation. What remains insufficiently understood are the interfaces between these fields: how formal law, professional guidance, institutional organisation, liability concerns, documentation, family communication, and actual clinical practice interact. Comparative research can make these relationships visible, identify what different arrangements solve and what difficulties they create, and provide a basis for informed collaboration across systems.
Project overview
The project investigates four domains:
Law and institutions – how death is defined, formally determined, documented, and made institutionally operative across different legal and healthcare systems.
Medicine and care – how clinicians recognize and determine death, make irreversible decisions under uncertainty, communicate with families, and navigate the relationships between end-of-life care, treatment withdrawal, death determination, and organ donation.
Culture, knowledge, and continuity – how people come to know that death has occurred, what happens when institutional and personal forms of certainty do not coincide, and how families and communities respond to uncertainty, informational gaps, memory, silence, ritual, and the redistribution of relationships and responsibilities after death.
Historical perspectives – how changing medical technologies, institutions, laws, and ideas of personhood have transformed the ways death is recognized, experienced, and integrated into social life.
Next steps
We are preparing a COST Action to build a European network. The emerging programme includes:
- comparative mapping of legal frameworks, professional guidance, institutional arrangements, and clinical practices;
- comparative analysis of the interfaces between death determination, treatment limitation, organ donation, and end-of-life care;
- research on documentation, legal uncertainty, professional responsibility, and the relationship between formal procedures and actual practice;
- study of family communication, access to knowledge, trust, uncertainty, and the consequences of institutional practices beyond the hospital;
- development and testing of adaptable comparative methods, principles, and practical tools;
- interdisciplinary workshops, researcher exchanges, training activities, and public engagement.
Download our discussion draft, and research
Invitation
We invite researchers and clinicians working on death determination, intensive care, end-of-life decision-making, palliative care, organ donation, medical law, bioethics, history, anthropology, and related fields to join the emerging collaboration.
We particularly welcome national expertise, comparative questions, empirical research, and perspectives that can help us understand the relationships between formal frameworks and actual institutional practice.
The emerging network
Dr Hristo Hristov – Anesthesiologist and intensive care specialist, Bulgaria. Research interests: formal death determination, brain death, organ donation, and comparative ICU practice.
Ilina Marinova – Psychologist and social and cultural anthropologist, Bulgaria. Research interests: death and dying, healthcare institutions, epistemic gaps, family communication, and social continuity.