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Approaches to patients and families with strong religious beliefs regarding end-of-life care

Romain, Marca; Sprung, Charles L.b

Current Opinion in Critical Care: December 2014 - Volume 20 - Issue 6 - p 668–672
doi: 10.1097/MCC.0000000000000148

Purpose of review End-of-life (EOL) decisions with limitations are made daily in ICUs around the world and may involve between 2 and 22% of patients admitted to an ICU. EOL decisions may be affected by numerous factors, including location and religion. This review aims to determine an approach to patients and families with strong religious views.

Recent findings Different religions have different approaches and beliefs regarding EOL care. Religious people choose more active life-sustaining measures than would nonreligious people. The patient's views on EOL care should be understood, although this is often not possible and the family members’ or surrogates’ understanding of the patient's wishes is relied upon. This is problematic as the family's wishes may differ from those of the patient. Family members may also have different religious beliefs or have different expressions of their beliefs. Through an open communication with the patient and/or family members, an understanding of the patient's views can be obtained and decisions regarding their involvement in decision making can be taken. Conflicts can be resolved by an interdisciplinary team approach including religious leaders.

Summary Through proper open communication and understanding of the patient's and/or family's views on EOL care and involvement of religious leaders, decisions can be made regarding how to further care for the patient.

aNephrology and Hypertension services

bGeneral Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel

Correspondence to Marc Romain, MBBCh, Nephrology and Hypertension services, Hadassah Hebrew University Medical Center, Kiryat Hadassah, Jerusalem, 91120, Israel. Tel: +972 505172631; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins