The impact of religion on changes in end-of-life practices in European intensive care units: a comparative analysis over 16 years

• DOI: 10.1007/s00134-023-07228-z
• Publication Date: 2023-10-09T08:59:07Z
• Authors: Joerg C. Schefold; Livio Ruzzante; Charles L. Sprung; Anastasiia Gruber; Eldar Soreide; Joseph Cosgrove; Sudakshina Mullick; Georgios Papathan...; Vasilios Koulouras; Paulo Azevedo Maia; Bara Ricou; Martin Posch; Philipp Metnitz; Hans-Henrik Bülow; Alexander Avidan; ; C. Sprung; R. Bernstein; A. Avidan; Charles L. Sprung; Matthew Anstey; Alexander Avidan; Elie Azoulay; Julie Benbenishty; Du Bin; Deborah Cook; Randy Curtis; Charles Feldman; Christiane Hartog; Gavin Joynt; Motoshi Kainuma; Mitchell Levy; R. K. Mani; Andrej Michalsen; Bara Ricou; Marcio Soares; Robert Truog; D. Ledoux; C. Ingels; D. Nalos; J. Gjedsted; C. Hartog; S. Zakynthinos; C. Mathas; G. Nakos; B. Koulouras; G. Papathanakos; O. Miskolci; C. L. Sprung; A. Avidan; V. de la Guardia; A. Farran; V. Van Heerden; M. Klein; P. Levin; A. Palo; A. Girbes; P. Maia; L. Bento; J. M. G. Garcia; A. Vidal Tegedor; B. Ricou; S. Marsch; J. C. Schefold; F. Esen; D. Brealey
• Keywords: End-of-Life Care; Pain medicine; Religious Life; Advance Care Planning

Religious beliefs affect end-of-life practices in intensive care units (ICUs). Changes over time were not investigated regarding religions. Twenty-two European ICUs (3 regions: Northern, Central, and Southern Europe) participated both Ethicus-1 (years 1999–2000) Ethicus-2 studies 2015–2016). Data of ICU patients who died or had limitations life-sustaining therapy analysed changes patient/physician religious affiliations. Frequencies, timing decision-making, affiliations physicians/patients compared using the same definitions. In total, 4592 adult (n = 2807 Ethicus-1, n 1785 Ethicus-2) analysed. studies, patient physician mostly Catholic, Greek Orthodox, Jewish, Protestant, unknown. Treating physicians (but patients) commonly reported no affiliation (18%). Distribution with respect to religion geographical regions comparable between two studies. Withholding [n 1143 (40.7%) 892 (50%) Ethicus-2] withdrawing 695 (24.8%) 692 (38.8%) most decided. No significant observed for any 16 years. The number discussions patients/ families/ increased, while mortality until first decision decreased. years appear unrelated their treating physicians, but effects religiosity and/or culture could be assessed. Shorter increased numbers family may indicate awareness importance decision-making ICU.