Τίτλος:
A survey of key opinion leaders on ethical resuscitation practices in 31 European Countries
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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 r2 = 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. © 2016 Elsevier Ireland Ltd.
Συγγραφείς:
Mentzelopoulos, S.D.
Bossaert, L.
Raffay, V.
Askitopoulou, H.
Perkins, G.D.
Greif, R.
Haywood, K.
Van de Voorde, P.
Xanthos, T.
Εκδότης:
Elsevier Ireland Ltd
Λέξεις-κλειδιά:
Article; Austria; Belgium; bioethics; Bosnia and Herzegovina; consensus development; Croatia; Cyprus; Czech Republic; Denmark; Finland; France; Germany; human; Hungary; Iceland; Italy; leadership; Luxembourg; Malta; medical society; Netherlands; Norway; Poland; priority journal; resuscitation; Romania; Russian Federation; Serbia; Slovakia; Slovenia; Spain; Sweden; Switzerland; Turkey (republic); United Kingdom; adult; child; ethics; Europe; female; heart arrest; leadership; male; medical ethics; preschool child; questionnaire; resuscitation; statistical model; terminal care, Adult; Cardiopulmonary Resuscitation; Child; Child, Preschool; Ethics, Medical; Europe; Female; Heart Arrest; Humans; Leadership; Linear Models; Male; Surveys and Questionnaires; Terminal Care
DOI:
10.1016/j.resuscitation.2015.12.010
