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

Mentzelopoulos, Spyros D and Bossaert, Leo and Raffay, Violetta and Askitopoulou, Helen and Perkins, Gavin D and Greif, Robert and Haywood, Kirstie and Van de Voorde, Patrick and Xanthos, Theodoros (2016) A survey of key opinion leaders on ethical resuscitation practices in 31 European Countries. Resuscitation, 100. pp. 11-7. ISSN 1873-1570. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

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Official URL: http://www.resuscitationjournal.com/article/S0300-...

Abstract

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.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WB Practice of medicine > WB400 Intensive care
WD Diseases and disorders of systemic, metabolic or environmental origin > WD400 Emergency medicine
Divisions: Clinical Support > Critical Care
Related URLs:
Depositing User: Mrs Caroline Tranter
Date Deposited: 30 Mar 2017 13:36
Last Modified: 30 Mar 2017 13:36
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1327

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