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- J L Vincent, J Berré, and J Creteur.
- Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium. jlvincen@ulb.ac.be
- Chron Respir Dis. 2004 Jan 1;1(2):115-20.
BackgroundMany deaths are now preceded by an end of life decision, particularly in the intensive care unit (ICU), but such practices vary considerably between countries, ICUs and individuals, depending on many factors including cultural and religious background, family and peer pressure and local practice.AimsIn this review, we will discuss the application of the four key ethical principles--beneficence, nonmaleficence, autonomy and distributive justice--to withdrawing/withholding decisions.MethodsDrawing data from several national and international studies, we then summarize the current situation across Europe regarding such practices before making some suggestions as to how we could facilitate the often difficult decision making process by improved communication between staff, patient and relatives.
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