The impact of religion on changes in end-of-life practices in European intensive care units : a comparative analysis over 16 years
© 2023. The Author(s)..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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| Enthalten in: |
Intensive care medicine - 49(2023), 11 vom: 09. Nov., Seite 1339-1348 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Schefold, Joerg C [VerfasserIn] |
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| Links: |
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| Themen: |
Active shortening of the dying process |
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| Anmerkungen: |
Date Completed 03.11.2023 Date Revised 11.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00134-023-07228-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363054006 |
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| 100 | 1 | |a Schefold, Joerg C |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of religion on changes in end-of-life practices in European intensive care units |b a comparative analysis over 16 years |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 03.11.2023 | ||
| 500 | |a Date Revised 11.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Active shortening of the dying process | |
| 650 | 4 | |a End of life | |
| 650 | 4 | |a Intensive care units | |
| 650 | 4 | |a Religion | |
| 650 | 4 | |a Withdrawing life-sustaining treatments | |
| 650 | 4 | |a Withholding life-sustaining treatments | |
| 700 | 1 | |a Ruzzante, Livio |e verfasserin |4 aut | |
| 700 | 1 | |a Sprung, Charles L |e verfasserin |4 aut | |
| 700 | 1 | |a Gruber, Anastasiia |e verfasserin |4 aut | |
| 700 | 1 | |a Soreide, Eldar |e verfasserin |4 aut | |
| 700 | 1 | |a Cosgrove, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Mullick, Sudakshina |e verfasserin |4 aut | |
| 700 | 1 | |a Papathanakos, Georgios |e verfasserin |4 aut | |
| 700 | 1 | |a Koulouras, Vasilios |e verfasserin |4 aut | |
| 700 | 1 | |a Maia, Paulo Azevedo |e verfasserin |4 aut | |
| 700 | 1 | |a Ricou, Bara |e verfasserin |4 aut | |
| 700 | 1 | |a Posch, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Metnitz, Philipp |e verfasserin |4 aut | |
| 700 | 1 | |a Bülow, Hans-Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Avidan, Alexander |e verfasserin |4 aut | |
| 700 | 0 | |a ETHICUS II Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Sprung, C |e investigator |4 oth | |
| 700 | 1 | |a Bernstein, R |e investigator |4 oth | |
| 700 | 1 | |a Avidan, A |e investigator |4 oth | |
| 700 | 1 | |a Sprung, Charles L |e investigator |4 oth | |
| 700 | 1 | |a Anstey, Matthew |e investigator |4 oth | |
| 700 | 1 | |a Avidan, Alexander |e investigator |4 oth | |
| 700 | 1 | |a Azoulay, Elie |e investigator |4 oth | |
| 700 | 1 | |a Benbenishty, Julie |e investigator |4 oth | |
| 700 | 1 | |a Bin, Du |e investigator |4 oth | |
| 700 | 1 | |a Cook, Deborah |e investigator |4 oth | |
| 700 | 1 | |a Curtis, Randy |e investigator |4 oth | |
| 700 | 1 | |a Feldman, Charles |e investigator |4 oth | |
| 700 | 1 | |a Hartog, Christiane |e investigator |4 oth | |
| 700 | 1 | |a Joynt, Gavin |e investigator |4 oth | |
| 700 | 1 | |a Kainuma, Motoshi |e investigator |4 oth | |
| 700 | 1 | |a Levy, Mitchell |e investigator |4 oth | |
| 700 | 1 | |a Mani, R K |e investigator |4 oth | |
| 700 | 1 | |a Michalsen, Andrej |e investigator |4 oth | |
| 700 | 1 | |a Ricou, Bara |e investigator |4 oth | |
| 700 | 1 | |a Soares, Marcio |e investigator |4 oth | |
| 700 | 1 | |a Truog, Robert |e investigator |4 oth | |
| 700 | 1 | |a Ledoux, D |e investigator |4 oth | |
| 700 | 1 | |a Ingels, C |e investigator |4 oth | |
| 700 | 1 | |a Nalos, D |e investigator |4 oth | |
| 700 | 1 | |a Gjedsted, J |e investigator |4 oth | |
| 700 | 1 | |a Hartog, C |e investigator |4 oth | |
| 700 | 1 | |a Zakynthinos, S |e investigator |4 oth | |
| 700 | 1 | |a Mathas, C |e investigator |4 oth | |
| 700 | 1 | |a Nakos, G |e investigator |4 oth | |
| 700 | 1 | |a Koulouras, B |e investigator |4 oth | |
| 700 | 1 | |a Papathanakos, G |e investigator |4 oth | |
| 700 | 1 | |a Miskolci, O |e investigator |4 oth | |
| 700 | 1 | |a Sprung, C L |e investigator |4 oth | |
| 700 | 1 | |a Avidan, A |e investigator |4 oth | |
| 700 | 1 | |a de la Guardia, V |e investigator |4 oth | |
| 700 | 1 | |a Farran, A |e investigator |4 oth | |
| 700 | 1 | |a Van Heerden, V |e investigator |4 oth | |
| 700 | 1 | |a Klein, M |e investigator |4 oth | |
| 700 | 1 | |a Levin, P |e investigator |4 oth | |
| 700 | 1 | |a Palo, A |e investigator |4 oth | |
| 700 | 1 | |a Girbes, A |e investigator |4 oth | |
| 700 | 1 | |a Maia, P |e investigator |4 oth | |
| 700 | 1 | |a Bento, L |e investigator |4 oth | |
| 700 | 1 | |a Garcia, J M G |e investigator |4 oth | |
| 700 | 1 | |a Tegedor, A Vidal |e investigator |4 oth | |
| 700 | 1 | |a Ricou, B |e investigator |4 oth | |
| 700 | 1 | |a Marsch, S |e investigator |4 oth | |
| 700 | 1 | |a Schefold, J C |e investigator |4 oth | |
| 700 | 1 | |a Esen, F |e investigator |4 oth | |
| 700 | 1 | |a Brealey, D |e investigator |4 oth | |
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