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Erschienen in: Intensive Care Medicine 3/2008

01.03.2008 | Review

The world's major religions' points of viewon end-of-life decisionsin the intensive care unit

verfasst von: Hans-Henrik Bülow, Charles L. Sprung, Konrad Reinhart, Shirish Prayag, Bin Du, Apostolos Armaganidis, Fekri Abroug, Mitchell M. Levy

Erschienen in: Intensive Care Medicine | Ausgabe 3/2008

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Abstract

Objective

Recent research has shown that the religious affiliation of both physicians and patients markedly influences end-of-life decisions in the intensive care unit in the Western world. The world's major religions' standings on withholding and withdrawing of therapy, on hastening of the death process when providing pain relief (double effect) and on euthanasia are described. This review also discusses whether nutrition should be provided to patients in a permanent vegetative state, and the issues of brain death and organ donation.

Design

The review is based on literature research and a description of the legislature in countries where religious rulings do influence secular law.

Results

Not all religions have distinct rulings on all the above-mentioned issues, but it is pointed out that all religions will probably have to develop rulings on these questions. The importance of patient autonomy in the Western (Christian) world is not necessarily an issue among other ethnic and religious groups, and guidelines are presented with methods to uncover and deal with different ethnic and religious views.

Conclusion

Many religious groupings are now spread world-wide (most notably Muslims), and with increasing globalization it is important that health-care systems take into account the religious beliefs of a wide variety of ethnic and religious groups when contemplating end-of-life decisions.
Literatur
1.
Zurück zum Zitat Koch KA, Rodeffer HD, Wears RL (1994) Changing patterns of terminal care management in an intensive care unit. Crit Care Med 22:233–243PubMedCrossRef Koch KA, Rodeffer HD, Wears RL (1994) Changing patterns of terminal care management in an intensive care unit. Crit Care Med 22:233–243PubMedCrossRef
2.
Zurück zum Zitat Prendergast TJ, Luce JM (1997) Increasing incidence of withholding and withdrawal of life support from the critically ill. Am J Respir Crit Care Med 155:15–20PubMed Prendergast TJ, Luce JM (1997) Increasing incidence of withholding and withdrawal of life support from the critically ill. Am J Respir Crit Care Med 155:15–20PubMed
3.
Zurück zum Zitat McLean RF, Tarshis J, Mazer D, Szalai JP (2000) Death in two Canadian intensive care units: Institutional difference and changes over time. Crit Care Med 28:100–103PubMedCrossRef McLean RF, Tarshis J, Mazer D, Szalai JP (2000) Death in two Canadian intensive care units: Institutional difference and changes over time. Crit Care Med 28:100–103PubMedCrossRef
4.
Zurück zum Zitat Sprung CL, Cohen SL, Sjøkvist P, Baras M, Bülow HH, Hovilehto S, Ledoux D, Lippert A, Maia P, Phelan D, Schobersberger W, Wennberg E, Woodcock T and The Ethicus Study Group (2003) End of life decisions in European intensive care units – the Ethicus Study. JAMA 290:790–797PubMedCrossRef Sprung CL, Cohen SL, Sjøkvist P, Baras M, Bülow HH, Hovilehto S, Ledoux D, Lippert A, Maia P, Phelan D, Schobersberger W, Wennberg E, Woodcock T and The Ethicus Study Group (2003) End of life decisions in European intensive care units – the Ethicus Study. JAMA 290:790–797PubMedCrossRef
5.
Zurück zum Zitat Kapadia F, Singh M, Divatia J, Vaidyanathan P, Udwadia FE, Raisinghaney SJ, Limaye HS, Karnad DR (2005) Limitation and withdrawal of intensive therapy at the end of life: practices in intensive care units in Mumbai, India. Crit Care Med 33:1436–1437CrossRef Kapadia F, Singh M, Divatia J, Vaidyanathan P, Udwadia FE, Raisinghaney SJ, Limaye HS, Karnad DR (2005) Limitation and withdrawal of intensive therapy at the end of life: practices in intensive care units in Mumbai, India. Crit Care Med 33:1436–1437CrossRef
6.
Zurück zum Zitat Vincent JL (1999) Forgoing life support in western European intensive care units: the results of an ethical questionnaire. Crit Care Med 27:1626–1633PubMedCrossRef Vincent JL (1999) Forgoing life support in western European intensive care units: the results of an ethical questionnaire. Crit Care Med 27:1626–1633PubMedCrossRef
7.
Zurück zum Zitat Christakis NA, Asch DA (1995) Physician characteristics associated with decisions to withdraw life support. Am J Public Health 85:367–372PubMed Christakis NA, Asch DA (1995) Physician characteristics associated with decisions to withdraw life support. Am J Public Health 85:367–372PubMed
8.
Zurück zum Zitat Sprung CL, Maia P, Bülow HH, Ricou B, Armaginidis A, Baras M, Wennberg E, Reinhart K, Cohen SL, Fries DR, Nakos G, Thijs LG and The Ethicus Study Group (2007) The impact of religion on end-of-life decisions in European intensive care units. Intensive Care Med 33:1732–1739PubMedCrossRef Sprung CL, Maia P, Bülow HH, Ricou B, Armaginidis A, Baras M, Wennberg E, Reinhart K, Cohen SL, Fries DR, Nakos G, Thijs LG and The Ethicus Study Group (2007) The impact of religion on end-of-life decisions in European intensive care units. Intensive Care Med 33:1732–1739PubMedCrossRef
9.
Zurück zum Zitat Daar SA, Khitamy BA (2001) Bioethics for clinicians. 21. Islamic bioethics. Can Med Assoc J 164:60–63 Daar SA, Khitamy BA (2001) Bioethics for clinicians. 21. Islamic bioethics. Can Med Assoc J 164:60–63
10.
Zurück zum Zitat Pauls M, Hutchinson RC (2002) Bioethics for clinicians: Protestant bioethics. Can Med Assoc J 166:339–344 Pauls M, Hutchinson RC (2002) Bioethics for clinicians: Protestant bioethics. Can Med Assoc J 166:339–344
11.
Zurück zum Zitat Hedayat KM, Pirzadeh R (2001) Issues in Islamic bioethics: a primer for the paediatrician. Pediatrics 108:965–971PubMedCrossRef Hedayat KM, Pirzadeh R (2001) Issues in Islamic bioethics: a primer for the paediatrician. Pediatrics 108:965–971PubMedCrossRef
12.
Zurück zum Zitat Blewett LA, Smoida SA, Fuentes C, Zuehlke EU (2003) Health care needs of the growing Latino population in rural America. J Rural Health 19:33–41PubMed Blewett LA, Smoida SA, Fuentes C, Zuehlke EU (2003) Health care needs of the growing Latino population in rural America. J Rural Health 19:33–41PubMed
13.
Zurück zum Zitat Coward H, Sidhu T (2000) Bioethics for clinicians: Hinduism and Sikhism. Can Med Assoc J 163:1167–1170 Coward H, Sidhu T (2000) Bioethics for clinicians: Hinduism and Sikhism. Can Med Assoc J 163:1167–1170
14.
Zurück zum Zitat Bowman KW, Hui EC (2000) Bioethics for clinicians: Chinese bioethics. Can Med Assoc J 163:1481–1485 Bowman KW, Hui EC (2000) Bioethics for clinicians: Chinese bioethics. Can Med Assoc J 163:1481–1485
15.
Zurück zum Zitat Rasool GH (2000) The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring. J Adv Nurs 32:1476–1484CrossRef Rasool GH (2000) The crescent and Islam: healing, nursing and the spiritual dimension. Some considerations towards an understanding of the Islamic perspectives on caring. J Adv Nurs 32:1476–1484CrossRef
16.
Zurück zum Zitat (No author listed) (2006) Annual Report on International Religious Freedom. Bureau of Democracy, Human Rights and Labour Washington, DC. (No author listed) (2006) Annual Report on International Religious Freedom. Bureau of Democracy, Human Rights and Labour Washington, DC.
17.
18.
Zurück zum Zitat Gatrad AR, Sheikh A (2001) Medical ethics and Islam: principles and practice. Arch Dis Child 84:72–75PubMedCrossRef Gatrad AR, Sheikh A (2001) Medical ethics and Islam: principles and practice. Arch Dis Child 84:72–75PubMedCrossRef
19.
Zurück zum Zitat Plougsgaard H (2007) Young Muslims and the terror debate. Jyllandsposten, Aarhus, Denmark 3 January, p 14 Plougsgaard H (2007) Young Muslims and the terror debate. Jyllandsposten, Aarhus, Denmark 3 January, p 14
20.
Zurück zum Zitat Pope John Paul II (1995) Evangelium Vitae, 25 March, www.vatican.va Pope John Paul II (1995) Evangelium Vitae, 25 March, www.vatican.va
21.
Zurück zum Zitat Pope John Paul II (1997) Catechismus Catholicae Ecclesiae Sections 2278 and 2279, Libreria Editrice Vaticana. ISBN 88–209-2428–5 Pope John Paul II (1997) Catechismus Catholicae Ecclesiae Sections 2278 and 2279, Libreria Editrice Vaticana. ISBN 88–209-2428–5
22.
Zurück zum Zitat (No author listed) (2000) Pontificia Academia pro vita: the dignity of the dying person. In: Libreria Editrice Vaticana (paperback) pp 480 (No author listed) (2000) Pontificia Academia pro vita: the dignity of the dying person. In: Libreria Editrice Vaticana (paperback) pp 480
23.
Zurück zum Zitat Shannon TA (2006) Nutrition and hydration: an analysis of the recent Papal statement in the light of the Roman Catholic bioethical tradition. Christ Bioeth 12:29–41PubMedCrossRef Shannon TA (2006) Nutrition and hydration: an analysis of the recent Papal statement in the light of the Roman Catholic bioethical tradition. Christ Bioeth 12:29–41PubMedCrossRef
24.
Zurück zum Zitat Clark P (2006) Tube feedings and persistent vegetative state patients: ordinary or extraordinary means. Christ Bioeth 12:43–64PubMedCrossRef Clark P (2006) Tube feedings and persistent vegetative state patients: ordinary or extraordinary means. Christ Bioeth 12:43–64PubMedCrossRef
25.
Zurück zum Zitat May AT (2003) Physician assisted suicide, euthanasia, and Christian bioethics: moral controversy in Germany. Christ Bioeth 9:273–283PubMedCrossRef May AT (2003) Physician assisted suicide, euthanasia, and Christian bioethics: moral controversy in Germany. Christ Bioeth 9:273–283PubMedCrossRef
26.
Zurück zum Zitat Hatzinikolaou N (2003) Prolonging life or hindering death? An orthodox perspective on death, dying and euthanasia. Christ Bioeth 9:187–201PubMedCrossRef Hatzinikolaou N (2003) Prolonging life or hindering death? An orthodox perspective on death, dying and euthanasia. Christ Bioeth 9:187–201PubMedCrossRef
27.
Zurück zum Zitat The Holy Synod of the Church of Greece, Bioethics Committee (2000) Press release, 17 August. Basic positions on the ethics of transplantation and euthanasia. www.bioethics.org.gr The Holy Synod of the Church of Greece, Bioethics Committee (2000) Press release, 17 August. Basic positions on the ethics of transplantation and euthanasia. www.bioethics.org.gr
28.
Zurück zum Zitat Steinberg A, Sprung CL (2006) The dying patient: new Israeli legislation. Intensive Care Med 32:1234–1237PubMedCrossRef Steinberg A, Sprung CL (2006) The dying patient: new Israeli legislation. Intensive Care Med 32:1234–1237PubMedCrossRef
29.
Zurück zum Zitat Bleich JD (1981) Euthanasia. In: Bleich JD (ed). Judaism and healing. Halachic perspectives. Ktav, New York, pp134–135 Bleich JD (1981) Euthanasia. In: Bleich JD (ed). Judaism and healing. Halachic perspectives. Ktav, New York, pp134–135
30.
Zurück zum Zitat Rosner F, Tendler MD (1980) Euthanasia. In: Rosner F, Tendler MD (eds). Practical medical Halacha. Feldheim. Jerusalem, p 56 Rosner F, Tendler MD (1980) Euthanasia. In: Rosner F, Tendler MD (eds). Practical medical Halacha. Feldheim. Jerusalem, p 56
32.
Zurück zum Zitat Cohen S, Sprung CL, Sjokvist P, Lippert A, Ricou B, Hovilehto S, Maia P, Reinhart K, Werdan K, Bülow HH, Woodcock T (2005) Communication of end of life decisions in European intensive care units – the Ethicus Study. Intensive Care Med 31:1215–1221PubMedCrossRef Cohen S, Sprung CL, Sjokvist P, Lippert A, Ricou B, Hovilehto S, Maia P, Reinhart K, Werdan K, Bülow HH, Woodcock T (2005) Communication of end of life decisions in European intensive care units – the Ethicus Study. Intensive Care Med 31:1215–1221PubMedCrossRef
33.
Zurück zum Zitat Steinberg A (2003) Encyclopedia of Jewish medical ethics, Feldheim, Jerusalem, pp 695–711 Steinberg A (2003) Encyclopedia of Jewish medical ethics, Feldheim, Jerusalem, pp 695–711
34.
Zurück zum Zitat Ebrahim AFH (2000) The living will (Wasiyat Al-Hayy): a study of its legality in the light of Islamic jurisprudence. Med Law 19:147–160PubMed Ebrahim AFH (2000) The living will (Wasiyat Al-Hayy): a study of its legality in the light of Islamic jurisprudence. Med Law 19:147–160PubMed
36.
Zurück zum Zitat da Costa DE, Ghazal H, Khusaiby SA, Gatrad AR (2002) Do not resuscitate orders in a neonatal ICU in a Muslim community. Arch Dis Child Fetal Neonatal Ed 86:F115–F119PubMedCrossRef da Costa DE, Ghazal H, Khusaiby SA, Gatrad AR (2002) Do not resuscitate orders in a neonatal ICU in a Muslim community. Arch Dis Child Fetal Neonatal Ed 86:F115–F119PubMedCrossRef
38.
Zurück zum Zitat Desai PN (1988) Medical ethics in India. J Med Phil 13:231–255 Desai PN (1988) Medical ethics in India. J Med Phil 13:231–255
40.
Zurück zum Zitat Low JA, Ng WC, Yap KB, Chan KM (2000) End-of-life issues – preferences and choices of a group of elderly Chinese subjects attending a day care centre in Singapore. Ann Acad Med Singapore 29:50–56PubMed Low JA, Ng WC, Yap KB, Chan KM (2000) End-of-life issues – preferences and choices of a group of elderly Chinese subjects attending a day care centre in Singapore. Ann Acad Med Singapore 29:50–56PubMed
41.
Zurück zum Zitat Lee JCY, Chen PP, Yeo JKS, So HY (2003) Hong Kong Chinese teachers' attitudes towards life-sustaining treatment in the dying patients. Hong Kong Med J 9:186–191PubMed Lee JCY, Chen PP, Yeo JKS, So HY (2003) Hong Kong Chinese teachers' attitudes towards life-sustaining treatment in the dying patients. Hong Kong Med J 9:186–191PubMed
42.
Zurück zum Zitat Bowman KW, Singer PA (2001) Chinese seniors' perspectives on end-of-life decisions. Soc Sci Med 53:455–464PubMedCrossRef Bowman KW, Singer PA (2001) Chinese seniors' perspectives on end-of-life decisions. Soc Sci Med 53:455–464PubMedCrossRef
43.
Zurück zum Zitat Kwak J, Haley WE (2005) Current research findings on end-of-life decision making among racially or ethnically diverse groups. Gerontologist 45:634–641PubMed Kwak J, Haley WE (2005) Current research findings on end-of-life decision making among racially or ethnically diverse groups. Gerontologist 45:634–641PubMed
44.
Zurück zum Zitat Liu JM, Lin WC, Chen YM, Wu HW, Yao NS, Chen LT, Whang-Peng J (1999) The status of the do-not-resuscitate order in Chinese clinical trial patients in a cancer centre. J Med Ethics 25:309–314PubMed Liu JM, Lin WC, Chen YM, Wu HW, Yao NS, Chen LT, Whang-Peng J (1999) The status of the do-not-resuscitate order in Chinese clinical trial patients in a cancer centre. J Med Ethics 25:309–314PubMed
45.
Zurück zum Zitat Tang ST, Liu TW, Lai MS, Liu LN, Chen CH, Koong SL (2006) Congruence of knowledge, experiences, and preferences for disclosure of diagnosis and prognosis between terminally-ill cancer patients and their family caregivers in Taiwan. Cancer Invest 24:360–366PubMedCrossRef Tang ST, Liu TW, Lai MS, Liu LN, Chen CH, Koong SL (2006) Congruence of knowledge, experiences, and preferences for disclosure of diagnosis and prognosis between terminally-ill cancer patients and their family caregivers in Taiwan. Cancer Invest 24:360–366PubMedCrossRef
46.
Zurück zum Zitat Ip M, Gilligan T, Koenig B, Raffin TA (1998) Ethical decision making in critical care in Hong Kong. Crit Care Med 26:447–451PubMedCrossRef Ip M, Gilligan T, Koenig B, Raffin TA (1998) Ethical decision making in critical care in Hong Kong. Crit Care Med 26:447–451PubMedCrossRef
48.
Zurück zum Zitat Shambhala Buddhist paper on end of life care. www.shambhala.org Shambhala Buddhist paper on end of life care. www.shambhala.org
49.
Zurück zum Zitat Ratanakul P (1988) Bioethics in Thailand: the struggle for Buddhist solutions. J Med Philos 13:301–312PubMed Ratanakul P (1988) Bioethics in Thailand: the struggle for Buddhist solutions. J Med Philos 13:301–312PubMed
50.
Zurück zum Zitat Eidelman LA, Jakobson DJ, Pizov R, Geber D, Leibovitz L, Sprung CL (1998) Foregoing life-sustaining treatment in an Israeli ICU. Intensive Care Med 24:162–166PubMedCrossRef Eidelman LA, Jakobson DJ, Pizov R, Geber D, Leibovitz L, Sprung CL (1998) Foregoing life-sustaining treatment in an Israeli ICU. Intensive Care Med 24:162–166PubMedCrossRef
51.
Zurück zum Zitat Christakis NA, Asch DA (1995) Physician characteristics associated with decisions to withdraw life support. Am J Public Health 85:367–372PubMed Christakis NA, Asch DA (1995) Physician characteristics associated with decisions to withdraw life support. Am J Public Health 85:367–372PubMed
52.
Zurück zum Zitat The Society of Critical Care Medicine Ethics Committee (1992) Attitudes of critical care medicine professionals concerning forgoing life-sustaining treatments. Crit Care Med 20:320–326CrossRef The Society of Critical Care Medicine Ethics Committee (1992) Attitudes of critical care medicine professionals concerning forgoing life-sustaining treatments. Crit Care Med 20:320–326CrossRef
53.
Zurück zum Zitat Matsumura S, Bito S, Liu H, Kahn K, Fukuhara S, Kagawa-Singer ML (2002) Acculturation of attitudes toward end-of-life care. J Gen Intern Med 17:531–539PubMedCrossRef Matsumura S, Bito S, Liu H, Kahn K, Fukuhara S, Kagawa-Singer ML (2002) Acculturation of attitudes toward end-of-life care. J Gen Intern Med 17:531–539PubMedCrossRef
54.
Zurück zum Zitat Engelhardt HT, Iltis AS (2005) End-of-life: the traditional Christian view. Lancet 366:1045–1049PubMedCrossRef Engelhardt HT, Iltis AS (2005) End-of-life: the traditional Christian view. Lancet 366:1045–1049PubMedCrossRef
55.
Zurück zum Zitat Mystakidou K, Parpa E, Tsilika E, Katsouda E, Vlahos L (2005) The evolution of euthanasia and its perceptions in Greek culture and civilization. Perspect Biol Med 48:95–104PubMedCrossRef Mystakidou K, Parpa E, Tsilika E, Katsouda E, Vlahos L (2005) The evolution of euthanasia and its perceptions in Greek culture and civilization. Perspect Biol Med 48:95–104PubMedCrossRef
56.
Zurück zum Zitat Brotzman GL, Butler DJ (1991) Cross-cultural issues in the disclosure of a terminal diagnosis. J Fam Pract 32:426–427PubMed Brotzman GL, Butler DJ (1991) Cross-cultural issues in the disclosure of a terminal diagnosis. J Fam Pract 32:426–427PubMed
58.
Zurück zum Zitat Yazigi A, Riachi M, Dabbar G (2005) Withholding and withdrawal of life-sustaining treatment in a Lebanese intensive care unit. Intensive Care Med 31:562–567PubMedCrossRef Yazigi A, Riachi M, Dabbar G (2005) Withholding and withdrawal of life-sustaining treatment in a Lebanese intensive care unit. Intensive Care Med 31:562–567PubMedCrossRef
59.
Zurück zum Zitat Klessig J (1992) Cross-cultural medicine. The effect of values and culture on life support decisions. West J Med 157:316–322PubMed Klessig J (1992) Cross-cultural medicine. The effect of values and culture on life support decisions. West J Med 157:316–322PubMed
60.
Zurück zum Zitat Grodin MA (1993) Religious advance directives: the convergence of law, religion, medicine and public health. Am J Pub Health 83:899–903PubMedCrossRef Grodin MA (1993) Religious advance directives: the convergence of law, religion, medicine and public health. Am J Pub Health 83:899–903PubMedCrossRef
61.
Zurück zum Zitat Ruark JE, Raffin TA (1988) Initiating and withdrawing life support. N Engl J Med 318:25–30PubMedCrossRef Ruark JE, Raffin TA (1988) Initiating and withdrawing life support. N Engl J Med 318:25–30PubMedCrossRef
Metadaten
Titel
The world's major religions' points of viewon end-of-life decisionsin the intensive care unit
verfasst von
Hans-Henrik Bülow
Charles L. Sprung
Konrad Reinhart
Shirish Prayag
Bin Du
Apostolos Armaganidis
Fekri Abroug
Mitchell M. Levy
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 3/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0973-8

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