PMID: 15366337Sep 16, 2004Paper

Ethics, attitude and practice in end-of-life care decision: an European perspective

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
S Nava

Abstract

Only in the last decade in Europe has there been increased attention dedicated to the end-of-life care in the hospital, especially in the Intensive Care Unit (ICU). The definitions of the potential decision are extremely important. Withholding is a planned decision not to institute therapies that were otherwise warranted, Withdrawal is the discontinuation of treatments that had been started, Terminal sedation consists of pain and symptom treatment with the possible side effect of shortening life, while Euthanasia means that a doctor is intentionally killing a person who is suffering unbearably and hopelessly at the latter's explicit informed request. The overall incidence of these practices in Europe is only partially known, but there are important differences between Countries or regions, reflecting the absence of a common strategy even within the European Community. Only <15% of ICU patients retain decision making capacity, allowing the impossibility of discussing the decision with them. It is rare that the patient's family is involved in the decision and when such case does arise, the relatives rate the communication with hospital staff poor. The "shared decision" taken together by physicians, nurses, and the patient's famil...Continue Reading

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