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Titolo:
End-of-life decisions in neonatal intensive care: physicians' self-reported practices in seven European countries
Autore:
Cuttini, M; Nadai, M; Kaminski, M; Hansen, G; de Leeuw, R; Lenoir, S; Persson, J; Rebagliato, M; Reid, M; de Vonderweid, U; Lenard, HG; Orzalesi, M; Saracci, R;
Indirizzi:
Burlo Garofolo Childrens Hosp, Epidemiol Unit, I-34137 Trieste, Italy Burlo Garofolo Childrens Hosp Trieste Italy I-34137 34137 Trieste, Italy Burlo Garofolo Childrens Hosp, Neonatal Intens Care Unit, I-34137 Trieste,Italy Burlo Garofolo Childrens Hosp Trieste Italy I-34137 -34137 Trieste,Italy INSERM, U149, Epidemiol Unit Womens & Childrens Hlth, Villejuif, France INSERM Villejuif France Unit Womens & Childrens Hlth, Villejuif, France Univ Halle Wittenberg, Dept Pediat, Halle, Germany Univ Halle Wittenberg Halle Germany enberg, Dept Pediat, Halle, Germany Univ Amsterdam, Dept Neonatol, Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands t Neonatol, Amsterdam, Netherlands Fac Med Toulouse, INSERM, CJF 8908, Unit Res Reprod, F-31073 Toulouse, France Fac Med Toulouse Toulouse France F-31073 eprod, F-31073 Toulouse, France Ctr Med Technol Assessment, Linkoping, Sweden Ctr Med Technol Assessment Linkoping Sweden sessment, Linkoping, Sweden Miguel Hernandez Univ, Dept Publ Hlth, Alicante, Spain Miguel Hernandez Univ Alicante Spain v, Dept Publ Hlth, Alicante, Spain Univ Glasgow, Dept Publ Hlth, Glasgow G12 8QQ, Lanark, Scotland Univ Glasgow Glasgow Lanark Scotland G12 8QQ ow G12 8QQ, Lanark, Scotland Univ Dusseldorf, Dept Pediat, D-4000 Dusseldorf, Germany Univ Dusseldorf Dusseldorf Germany D-4000 at, D-4000 Dusseldorf, Germany Bambino Gesu Childrens Hosp, Neonatal Intens Care Unit, Rome, Italy Bambino Gesu Childrens Hosp Rome Italy al Intens Care Unit, Rome, Italy Natl Res Council, IFC, Div Epidemiol, Pisa, Italy Natl Res Council Pisa Italy es Council, IFC, Div Epidemiol, Pisa, Italy
Titolo Testata:
LANCET
fascicolo: 9221, volume: 355, anno: 2000,
pagine: 2112 - 2118
SICI:
0140-6736(20000617)355:9221<2112:EDINIC>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
ETHICAL DECISIONS; INFANTS; UNIT; SUPPORT; DEATH; NETHERLANDS; DILEMMAS; NURSERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Cuttini, M Burlo Garofolo Childrens Hosp, Epidemiol Unit, Via Istria 65-1,I-34137 Trieste, Italy Burlo Garofolo Childrens Hosp Via Istria 65-1 Trieste Italy I-34137
Citazione:
M. Cuttini et al., "End-of-life decisions in neonatal intensive care: physicians' self-reported practices in seven European countries", LANCET, 355(9221), 2000, pp. 2112-2118

Abstract

Background The ethical issue of foregoing life-sustaining treatment for newborn infants at high risk of death or severe disability is extensively debated, but there is little information on how physicians in different countries actually confront this issue to reach end-of-life decisions. The EURONIC project aimed to investigate practices as reported by physicians themselves. Methods The study recruited a large, representative sample of 122 neonatalintensive-care units (NICUs) by census tin Luxembourg, the Netherlands, and Sweden) or stratified random sampling (in France, Germany, the UK, Italy,and Spain) with an overall response rate of 86%. Physicians' practices of end-of-life decision-making were investigated through an anonymous, self-administered questionnaire. 1235 completed questionnaires were returned (response rate 89%). Findings In all countries, most physicians reported having been involved at least once in setting limits to intensive care because of incurable conditions (61-96%); smaller proportions reported such involvement because of a baby's poor neurological prognosis (46-90%). Practices such as continuationof current treatment without intensification and withholding of emergency manoeuvres were widespread, but withdrawal of mechanical ventilation was reported by variable proportions (28-90%). Only in France (73%) and the Netherlands (47%) was the administration of drugs with the aim of ending life reported with substantial frequency. Age, length of professional experience, and the importance of religion in the physician's life affected the likelihood of reporting of non-treatment decisions. Interpretation A vast majority of neonatologists in European NICUs have been involved in end-of-life limitation of treatments, but type of decision-making varies among countries, Cultur-related and other country-specific factors are more relevant than characteristics of individual physicians or units in explaining such variability.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 03:34:06