Review article
https://doi.org/10.26800/LV-145-supl4-14
Are we ready for end of life decisions in intensive medicine?
Vjeran Leventić
; Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinički bolnički centar Osijek
Nenad Nešković
Slavica Kvolik
Gordana Kristek
Sonja Škiljić
Ivana Haršanji-Drenjančević
Abstract
Objectives: To compare the attitudes of intensive care physicians at Clinical Hospital Center Osijek regarding end-of-life care in intensive care units (ICUs) with actual practice. Participants and methods: The study consisted of two parts: conducting an anonymous survey among specialist physicians working in ICUs and retrospective analysis of data on deceased patients in 2022, collected from the Hospital Information System (HIS). Results: The survey revealed that the majority of physicians did not adhere to guidelines for improving palliative care in ICUs and that there were ethical dilemmas regarding the limitation of life-sustaining measures. The main reasons for non-adherence to the guidelines were identified as a lack of legal protection and fear of colleagues’ and families’ perception. Analysis of data from the HIS identified a significantly higher number of deaths following unsuccessful cardiopulmonary resuscitation (CPR) compared to the rest of Europe, as well as a lack of written documentation of decisions to withhold CPR and specific life-sustaining measures. Although there was a protocol for making decisions on life-sustaining measures limitations, the majority of physicians were unaware of its existence and did not complete it. Conclusion: These findings highlight the need for improvement in decision-making regarding end-of-life care in ICUs.
Keywords
CROATIA; INTENSIVE CARE UNIT; END OF LIFE; ETHICS; PALLIATIVE CARE
Hrčak ID:
310277
URI
Publication date:
20.11.2023.
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