End-of-life decisions in Hungarian intensive care units

L. Zubek, L. Szabó, Cs Diószeghy, J. Gál, G. Élö

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The awareness of local practice of end-of-life decisions in accordance with the law and ethical principles is essential for intensive care physicians in all countries. The first step for the required social dialogue is to investigate local practice. We performed the first Hungarian survey with the aim of better understanding local practice in end-of-life decisions in intensive care units. Questionnaires were sent out electronically to 743 members of the Hungarian Society of Anaesthesiology and Intensive Care. Respecting anonymity, we have statistically evaluated 103 replies (response rate 13.8%) and compared the results to data from other European countries. The results show that the practice of intensive care physicians in Hungary is rather paternalistic. Intensive care physicians generally make their decisions alone (3.75/5 points) without considering the opinion of the patient (2.57/5 points), the relatives (2.14/5 points) or other medical staff (2.37/5 points). Furthermore, they prefer not to start a form of treatment rather than to withdraw an ongoing one. Nevertheless, the frequency of end-of-life decisions (3 to 9% of intensive care unit patients) made in Hungarian intensive care units is less than in other European countries. End-of-life decisions are part of medical practice. Since the legal and ethical framework is unclear, practice varies between locations and mostly depends on individual decisions rather than established protocols or guidance. For end-of-life decisions, self-determination must be supported and a dialogue must be established between lawmakers and physicians.

Original languageEnglish
Pages (from-to)116-121
Number of pages6
JournalAnaesthesia and Intensive Care
Volume39
Issue number1
Publication statusPublished - Jan 1 2011

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Keywords

  • 'Do not resuscitate' (DNR) order
  • Bioethics
  • End-of-life decision
  • Withdrawing treatment
  • Withholding treatment

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

Zubek, L., Szabó, L., Diószeghy, C., Gál, J., & Élö, G. (2011). End-of-life decisions in Hungarian intensive care units. Anaesthesia and Intensive Care, 39(1), 116-121.