ArticleIntensive care medicine2013
The luck of the draw: physician-related variability in end-of-life decision-making in intensive care.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Psychological Determinants of Physician Variation in End-of-Life Treatment Intensity: A Systematic Review and Meta-Synthesis.Journal of general internal medicine · 2023Pooled it
- Making Medical Treatment Decisions for Unrepresented Patients in the ICU. An Official American Thoracic Society/American Geriatrics Society Policy Statement.American journal of respiratory and critical care medicine · 2020Guideline
- American Geriatrics Society position statement: Making medical treatment decisions for unrepresented older adults.Journal of the American Geriatrics Society · 2025Article
- Using Electronic Health Records to Identify the Daily Primary Provider During Hospitalization.Critical care explorations · 2024Article
- Association between physician age and patterns of end-of-life care among older Americans.Journal of the American Geriatrics Society · 2024Article
- Consent to testing for brain death.Journal of medical ethics · 2024Article
- Deference or critical engagement: how should healthcare practitioners use clinical ethics guidance?Monash bioethics review · 2024Article
- Practice and Predictors of Do-Not-Resuscitate Orders in a Tertiary-Care Intensive Care Unit in Saudi Arabia.Critical care research and practice · 2024Article
- The role of clinical phenotypes in decisions to limit life-sustaining treatment for very old patients in the ICU.Annals of intensive care · 2023Article
- Contribution of information about acute and geriatric characteristics to decisions about life-sustaining treatment for old patients in intensive care.BMC medical informatics and decision making · 2023Article
- "Death as the One Great Certainty": ethical implications of children with irreversible cardiorespiratory failure and dependence on extracorporeal membrane oxygenation.Frontiers in pediatrics · 2023Article
- Team-family conflicts over end-of-life decisions in ICU: A survey of French physicians' beliefs.PloS one · 2023Article
- The Meaning Given to Bioethics as a Source of Support by Physicians Who Care for Children Who Require Long-Term Ventilation.Qualitative health research · 2022Article
- Derivation and performance of an end-of-life practice score aimed at interpreting worldwide treatment-limiting decisions in the critically ill.Critical care (London, England) · 2022Observational
- Survey of End-of-Life Care in Intensive Care Units in Ain Shams University Hospitals, Cairo, Egypt.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2022Article
- Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?The American journal of bioethics : AJOB · 2021Review
- The intractable problems with brain death and possible solutions.Philosophy, ethics, and humanities in medicine : PEHM · 2021Review
- Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients: a CENTER-TBI study.Intensive care medicine · 2021Article
- Rationing in the Pediatric Intensive Care Unit-ethical or unethical?Translational pediatrics · 2021Review
- Intensive care doctors and nurses personal preferences for Intensive Care, as compared to the general population: a discrete choice experiment.Critical care (London, England) · 2021Observational
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo critically analyze physician-related variability in end-of-life decision-making in intensive care.
methodsAn ethical analysis of factors contributing to physician-related variability in end-of-life decision-making.
resultsThere is variability in decision-making about life support, both within and between intensive care units. Physician age, race, religion, attitude to risk, and personality factors have been associated with decisions to provide or limit life-sustaining treatment, though it is unclear how much these factors affect patient outcome. Inconsistency in decision-making appears worryingly arbitrary, and may mean that patients' values are sometimes being ignored or overridden. However, physician influence on decisions may also sometimes be appropriate and unavoidable, particularly where patient values are unclear.
conclusionsWe argue that, although physician-related variability in end-of-life care can never be eliminated entirely, it is potentially ethically problematic. We outline four potential strategies for reducing the "roster lottery."
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.