Discrepancies between Perceptions by Physicians and Nursing Staff of Intensive Care Unit End-of-Life Decisions

Several studies have pointed out ethical shortcomings in the deci- legitimate when there is disagreement among the caregivers sion-making process for withholding or withdrawing life-support- (15). The considerable moral responsibility conferred on ing treatments. We conducted a study to evaluate the perceptions nurses by their unique proximity to the patient and his/her of all caregivers involved in this process in the intensive care unit. relatives and their interaction with the physician team are A closed-ended questionnaire was completed by 3,156 nursing staff strong arguments in favor of including nurses in the specific members and 521 physicians from 133 French intensive care units DFLST process (14, 16–19). Recently, two lawsuits in France (participation rate, 42%). Decision-making processes were per- and one in Belgium have been filed against ICU physicians ceived as satisfactory by 73 % of physicians and by only 33 % of the who had withdrawn mechanical ventilation from hopelessly nursing staff. More than 90 % of caregivers believed that decision- ill patients (20–22). In these three instances, the lawsuits wer