A national survey of Italian physicians’ attitudes towards end-of-life decisions following the death of Eluana Englaro: reply to M.Y. Rady

Solarino, Biagio; Bruno, Francesco; Frati, Giacomo; Dell’Erba, Alessandro; Frati, Paola

doi:10.1007/s00134-011-2276-3

Cited by 2 publications

(2 citation statements)

References 9 publications

(7 reference statements)

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“…The multiple measures before the judgment under review approved the appointment of a Guardian in the period before the onset of the condition of incapacity and they were in agreement with the arguments put forward by Judges in the case “Englaro” [15], stressing that the loss of consciousness cannot also result in the loss of fundamental rights and freedoms such as self-determination in personal choices. Only the appointment of the Guardian could rekindle the dialogue between doctor and patient, ensuring respect for the rights of a personal nature.…”

Section: Discussionsupporting

confidence: 54%

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

Busardò

Bello

Gulino

et al. 2014

BioMed Research International

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Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life's rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives.

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Section: Discussionsupporting

confidence: 54%

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

Busardò

Bello

Gulino

et al. 2014

BioMed Research International

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“…In the American, British, and Belgian surveys, 56–89% considered the withdrawal of artificial nutrition and hydration appropriate. Even in an Italian survey from 2011 a higher percentage of the physicians (66%) believed that the withdrawal of artificial nutrition and hydration to be appropriate depending on the patient’s wish [30]. On the other hand, surveys from Japan, and an older German survey of 283 medical directors of neurological, neurosurgical, and rehabilitation departments reported much lower rates of agreement with limitation of treatment (30, 58%) and withdrawal of artificial nutrition and hydration (3, 16%) [16, 20, 31].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists

Kuehlmeyer¹,

Racine

Palmour

et al. 2012

J Neurol

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Diagnosis and decisions on life-sustaining treatment (LST) in disorders of consciousness, such as the vegetative state (VS) and the minimally conscious state (MCS), are challenging for neurologists. The locked-in syndrome (LiS) is sometimes confounded with these disorders by less experienced physicians. We aimed to investigate (1) the application of diagnostic knowledge, (2) attitudes concerning limitations of LST, and (3) further challenging aspects in the care of patients. A vignette-based online survey with a randomized presentation of a VS, MCS, or LiS case scenario was conducted among members of the German Society for Neurology. A sample of 503 neurologists participated (response rate 16.4%). An accurate diagnosis was given by 86% of the participants. The LiS case was diagnosed more accurately (94%) than the VS case (79%) and the MCS case (87%, p < 0.001). Limiting LST for the patient was considered by 92, 91, and 84% of the participants who accurately diagnosed the VS, LiS, and MCS case (p = 0.09). Overall, most participants agreed with limiting cardiopulmonary resuscitation; a minority considered limiting artificial nutrition and hydration. Neurologists regarded the estimation of the prognosis and determination of the patients’ wishes as most challenging. The majority of German neurologists accurately applied the diagnostic categories VS, MCS, and LiS to case vignettes. Their attitudes were mostly in favor of limiting life-sustaining treatment and slightly differed for MCS as compared to VS and LiS. Attitudes toward LST strongly differed according to circumstances (e.g., patient’s will opposed treatment) and treatment measures.

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A national survey of Italian physicians’ attitudes towards end-of-life decisions following the death of Eluana Englaro: reply to M.Y. Rady

Cited by 2 publications

References 9 publications

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists

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