(DIS)AGreement of Relatives Regarding Ethical End-of-life Decisions in ICU.

Last updated: December 23, 2024
Sponsor: Société Française d'Anesthésie et de Réanimation
Overall Status: Active - Recruiting

Phase

N/A

Condition

N/A

Treatment

observational

Clinical Study ID

NCT05768906
(DIS)AGREE - 2022-02
  • Ages > 18
  • All Genders

Study Summary

In the ICU, the vast majority of patients die following a life-sustaining therapies (LST) limitation decision. Most often, the patient is not able to express himself and has not made his wishes known beforehand, for example in the form of advance directives. The "relatives" are then the only recourse to state the patient's wishes, without any guarantee that they are aware of them. In France, the final decision is made by the physician (or the medical team) who is responsible for it. In this context, disagreements and even real legal conflicts on LST limitation decisions between relatives and physicians seem to be more and more frequent. To our knowledge, few data exist on the frequency of these disagreements over LST limitation decisions.

The main objective of this study is to evaluate the frequency of disagreements between relatives and physicians over LST limitation decisions in adult intensive care.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Consecutive inclusion of all situations in which a life-sustaining therapieslimitation decision was made

  • Patients hospitalized in a French intensive care unit

  • Age of the patient ≥ 18 years

  • If relatives are present, age of at least one of the relatives ≥ 18 years NB:situations of "non-re-admission" decisions in intensive care are not taken intoaccount in the inclusion criteria.

Exclusion

Exclusion Criteria:

  • Minor patient

  • Patient under guardianship

  • Conscious patient, able to express himself/herself and able to decide jointly withthe medical team

  • Patient for whom a life-sustaining therapies limitation decision was already madeprior to ICU admission.

Study Design

Total Participants: 400
Treatment Group(s): 1
Primary Treatment: observational
Phase:
Study Start date:
July 01, 2023
Estimated Completion Date:
March 15, 2025

Study Description

Context In the ICU, the vast majority of patients die following a life-sustaining therapies (LST) limitation decision. Most often, the patient is not able to express himself and has not made his wishes known beforehand, for example in the form of advance directives. The "relatives" are then the only recourse to state the patient's wishes, without any guarantee that they are aware of them. In France, the final decision is made by the physician (or the medical team) who is responsible for it. In this context, disagreements and even real legal conflicts on LST limitation decisions between relatives and physicians seem to be more and more frequent. To our knowledge, few data exist on the frequency of these disagreements over LST limitation decisions.

Purpose The main objective of this study is to evaluate the frequency of disagreements between relatives and physicians over LST limitation decisions in adult intensive care.

The secondary objectives are:

  • To assess the level of agreement/disagreement between family members and physicians regarding LST limitation decisions

  • To assess the proportion of disagreements experienced as conflictual

  • To assess the impact of the disagreement on the LST limitation decision (implementation of the decision, time between the decision and its implementation, length of hospitalization...)

  • To describe possible factors that contribute to disagreement and conflict

  • To describe national LST limitation decision-making practices.

Connect with a study center

  • CH d'Aurillac (CH Henri Mondor)

    Aurillac, 15000
    France

    Site Not Available

  • Hôpital Saint Camille

    Bry-sur-Marne, 94360
    France

    Site Not Available

  • CHU de Clermont Ferrand - Hôpital Gabriel Montpied

    Clermont-Ferrand, 63000
    France

    Active - Recruiting

  • Hôpital Beaujon - Réanimation chirurgicale polyvalente

    Clichy, 92110
    France

    Site Not Available

  • Hôpital Beaujon - Réanimation hépato-digestive

    Clichy, 92110
    France

    Site Not Available

  • CH de Dieppe

    Dieppe, 76202
    France

    Site Not Available

  • CHU de Dijon

    Dijon, 21079
    France

    Site Not Available

  • Hôpital Simone Veil- Eaubonne

    Eaubonne, 95602
    France

    Site Not Available

  • CH de Grasse

    Grasse, 06130
    France

    Site Not Available

  • GHEF (Grand Hôpital de l'Est Francilien)-Site de Marne la Vallée

    Jossigny, 77600
    France

    Site Not Available

  • CHU de Grenoble-Alpes

    La Tronche, 38700
    France

    Site Not Available

  • CH de Lens

    Lens, 62300
    France

    Site Not Available

  • CHU de Montpellier - Gui de Chauliac

    Montpellier, 34295
    France

    Site Not Available

  • Fondation Ophtalmologique Adolphe de Rothschild

    Paris, 75019
    France

    Site Not Available

  • Hôpital Lariboisière_APHP - Réanimation Chirurgicale Polyvalente

    Paris, 75010
    France

    Site Not Available

  • Institut Mutualiste Montsouris -

    Paris, 75014
    France

    Site Not Available

  • Hôpital privé Claude Galien

    Quincy-sous-Sénart, 91480
    France

    Site Not Available

  • CHU de Reims - Réanimation chirurgicale

    Reims, 51092
    France

    Site Not Available

  • CHU de Toulouse-Rangueil - Réanimation Polyvalente

    Toulouse, 31400
    France

    Site Not Available

  • CHBA Vannes-Auray

    Vannes, 56017
    France

    Site Not Available

  • CH Versailles

    Versailles, 78150
    France

    Site Not Available

  • HIA Robert Picqué

    Villenave-d'Ornon, 33140
    France

    Site Not Available

  • Médipôle Lyon Villeurbanne

    Villeurbanne, 69100
    France

    Site Not Available

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