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December 10, 2003

End-of-Life Practices in European Intensive Care UnitsEnd-of-Life Practices in European Intensive Care Units

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(22):2938-2940. doi:10.1001/jama.290.22.2938-a

To the Editor: Dr Sprung and colleagues1 stated that "active shortening of the dying process" was rare in their sample and affected only 2% of patients who died after life-sustaining treatment was withheld or withdrawn.

A recent European survey,2 on the other hand, has indicated that 40% of ICU physicians admitted that they sometimes administered drugs to hasten death. Likewise, physicians at neonatal ICUs in 2 European countries admitted with significant frequency (in France, 73% of respondents; in the Netherlands, 47%) that they had decided to administer drugs with the purpose of ending the patient's life.3 In Italy, a survey found that the deliberate use of lethal doses of drugs was admitted by about 4% of ICU physicians and was considered ethically acceptable by about 16%.4

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