A survey of key opinion leaders on ethical resuscitation practices in 31 European Countries

被引：32

作者：

Mentzelopoulos, Spyros D. ^{[1
]}

Bossaert, Leo ^{[2
]}

Raffay, Violetta ^{[3
]}

Askitopoulou, Helen ^{[4
,5
]}

Perkins, Gavin D. ^{[6
,7
]}

Greif, Robert ^{[8
,9
]}

Haywood, Kirstie ^{[10
]}

Van de Voorde, Patrick ^{[11
,12
,13
]}

Xanthos, Theodoros ^{[1
,14
]}

机构：

[1] Univ Athens, Sch Med, GR-11527 Athens, Greece

[2] Univ Antwerp, B-2020 Antwerp, Belgium

[3] Municipal Inst Emergency Med Novi Sad, Novi Sad, Serbia

[4] Univ Crete, Sch Med, Iraklion, Greece

[5] European Soc Emergency Med EuSEM, Eth Comm, London, England

[6] Univ Warwick, Warwick Med Sch, Coventry CV4 7AL, W Midlands, England

[7] Heart England NHS Fdn Trust, Crit Care Unit, Birmingham, W Midlands, England

[8] Univ Hosp Bern, CH-3010 Bern, Switzerland

[9] Univ Bern, Bern, Switzerland

[10] Univ Warwick, Warwick Med Sch, Royal Coll Nursing Res Inst, Coventry CV4 7AL, W Midlands, England

[11] Univ Hosp, Ghent, Belgium

[12] Univ Ghent, B-9000 Ghent, Belgium

[13] Fed Dept Hlth, Ghent, Belgium

[14] Midwestern Univ, Chicago, IL USA

来源：

RESUSCITATION | 2016年 / 100卷

关键词：

Cardiac arrest; Resuscitation; Bioethics; End of life care; Emergency care; CARDIOPULMONARY-RESUSCITATION; INVASIVE PROCEDURES; NURSES ATTITUDES; FAMILY PRESENCE; CRITICAL-CARE; DECISIONS;

D O I：

10.1016/j.resuscitation.2015.12.010

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Europe is a patchwork of 47 countries with legal, cultural, religious, and economic differences. A prior study suggested variation in ethical resuscitation/end-of-life practices across Europe. This study aimed to determine whether this variation has evolved, and whether the application of ethical practices is associated with emergency care organisation. Methods: A questionnaire covering four domains of resuscitation ethics was developed based on consensus: (A) Approaches to end-of-life care and family presence during cardiopulmonary resuscitation; (B) Determinants of access to best resuscitation and post-resuscitation care; (C) Diagnosis of death and organ donation (D) Emergency care organisation. The questionnaire was sent to representatives of 32 countries. Responses to 4-choice or 2-choice questions pertained to local legislation and common practice. Positive responses were graded by 1 and negative responses by 0; grades were reconfirmed/corrected by respondents from 31/32 countries (97%). For each resuscitation/end-of-life practice a subcomponent score was calculated by grades' summation. Subcomponent scores' summation resulted in domain total scores. Results: Data from 31 countries were analysed. Domains A, B, and D total scores exhibited substantial variation (respective total score ranges, 1-41, 0-19 and 9-32), suggesting variable interpretation and application of bioethical principles, and particularly of autonomy. Linear regression revealed a significant association between domain A and D total scores (adjusted r(2) = 0.42, P<0.001). Conclusions: According to key experts, ethical practices and emergency care still vary across Europe. There is need for harmonised legislation, and improved, education-based interpretation/application of bioethical principles. Better application of ethical practices may be associated with improved emergency care organisation. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

引用

页码：11 / 17

页数：7

共 26 条

[1] Unanimity on Death with Dignity - Legalizing Physician-Assisted Dying in Canada [J].