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Title
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A survey of key opinion leaders on ethical resuscitation practices in 31 European Countries
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Author
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Abstract
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| 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved. |
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Language
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English
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Source (journal)
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Resuscitation. - Limerick, 1972, currens
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Publication
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Limerick
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2016
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ISSN
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0300-9572
[print]
1873-1570
[online]
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DOI
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10.1016/J.RESUSCITATION.2015.12.010
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Volume/pages
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100
(2016)
, p. 11-17
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ISI
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000370181300008
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Pubmed ID
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26776899
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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