Skip to main content
  • Poster presentation
  • Published:

End-of-life decisions in Hungarian intensive care units

Introduction

The acknowledgement of local practice with respect to end-of-life decisions in accordance with laws and ethical principles is inevitable for intensive physicians in all countries. The first step for the required social dialogue is to search for local customs for harmonisation with ethical and legal regulations, as well as the interests of physicians and patients.

Methods

In 2007 we performed the first Hungarian survey with the purpose to learn more about the local practice of end-of-life decisions. Questionnaires were sent out electronically to 743 registered members of the Hungarian Society of Anaesthesiology and Intensive Care. Respecting anonymity we have statistically evaluated 103 replies (response rate was 13.8%) and compared with data from other European countries.

Results

As expected, it turned out from the replies that the practice of domestic intensive care physicians is very paternal and this is promoted by legal regulations that share a similar character. Intensive care physicians generally make their decisions alone (3.75/5 points) without respecting the opinion of the patient (2.57/5 points), the relatives (2.14/5 points) or other medical personnel (2.37/5 points). Furthermore they prefer not to start a therapy rather than withdraw an ongoing treatment. Nevertheless, the frequency of end-of-life decisions (3 to 9% of ICU patients) is similar to other European countries.

Conclusions

Hungarian intensive care physicians make end-of-life actions routinely. They usually decide based on their own opinion, slightly considering the opinion of nursing personnel, the patients or their relatives. They are not supported by the Hungarian legal regulation in making these decisions. Although the living will and the advanced directive are both acknowledged, they are not as widespread as required. Our study is the first step to commence a social dialogue, which is taken in the evolution of end-of-life decision-making procedures.

References

  1. Heide A, et al.: End of life decision making in six European countries: descriptive study. Lancet 2003, 362: 345-350. 10.1016/S0140-6736(03)14019-6

    Article  Google Scholar 

  2. Sprung CL, et al.: End-of-life practices in European intensive care units; the Ethicus Study. JAMA 2003, 290: 790-797. 10.1001/jama.290.6.790

    Article  Google Scholar 

  3. Vincent JL, et al.: Forgoing life support in western European intensive care units: the results of an ethical questionnaire. Crit Care Med 1999, 27: 1626-1633. 10.1097/00003246-199908000-00042

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zubek, L., Élő, G. & Szabó, L. End-of-life decisions in Hungarian intensive care units. Crit Care 14 (Suppl 1), P602 (2010). https://doi.org/10.1186/cc8834

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc8834

Keywords