Schefold, Joerg C; Ruzzante, Livio; Sprung, Charles L; Gruber, Anastasiia; Soreide, Eldar; Cosgrove, Joseph; Mullick, Sudakshina; Papathanakos, Georgios; Koulouras, Vasilios; Maia, Paulo Azevedo; Ricou, Bara; Posch, Martin; Metnitz, Philipp; Bülow, Hans-Henrik; Avidan, Alexander (2023). The impact of religion on changes in end-of-life practices in European intensive care units: a comparative analysis over 16 years. Intensive care medicine, 49(11), pp. 1339-1348. Springer 10.1007/s00134-023-07228-z
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PURPOSE
Religious beliefs affect end-of-life practices in intensive care units (ICUs). Changes over time in end-of-life practices were not investigated regarding religions.
METHODS
Twenty-two European ICUs (3 regions: Northern, Central, and Southern Europe) participated in both Ethicus-1 (years 1999-2000) and Ethicus-2 studies (years 2015-2016). Data of ICU patients who died or had limitations of life-sustaining therapy were analysed regarding changes in end-of-life practices and patient/physician religious affiliations. Frequencies, timing of decision-making, and religious affiliations of physicians/patients were compared using the same definitions.
RESULTS
In total, 4592 adult ICU patients (n = 2807 Ethicus-1, n = 1785 Ethicus-2) were analysed. In both studies, patient and physician religious affiliations were mostly Catholic, Greek Orthodox, Jewish, Protestant, or unknown. Treating physicians (but not patients) commonly reported no religious affiliation (18%). Distribution of end-of-life practices with respect to religion and geographical regions were comparable between the two studies. Withholding [n = 1143 (40.7%) Ethicus-1 and n = 892 (50%) Ethicus-2] and withdrawing [n = 695 (24.8%) Ethicus-1 and n = 692 (38.8%) Ethicus-2] were most commonly decided. No significant changes in end-of-life practices were observed for any religion over 16 years. The number of end-of-life discussions with patients/ families/ physicians increased, while mortality and time until first decision decreased.
CONCLUSIONS
Changes in end-of-life practices observed over 16 years appear unrelated to religious affiliations of ICU patients or their treating physicians, but the effects of religiosity and/or culture could not be assessed. Shorter time until decision in the ICU and increased numbers of patient and family discussions may indicate increased awareness of the importance of end-of-life decision-making in the ICU.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care |
UniBE Contributor: |
Schefold, Jörg Christian, Ruzzante, Livio |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1432-1238 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
10 Oct 2023 11:59 |
Last Modified: |
03 Nov 2023 00:16 |
Publisher DOI: |
10.1007/s00134-023-07228-z |
PubMed ID: |
37812228 |
Uncontrolled Keywords: |
Active shortening of the dying process End of life Intensive care units Religion Withdrawing life-sustaining treatments Withholding life-sustaining treatments |
BORIS DOI: |
10.48350/187028 |
URI: |
https://boris.unibe.ch/id/eprint/187028 |
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