ReviewCureus2026
Spirituality and Religiosity in End-of-Life Decision-Making in Intensive Care Units: A Systematic Review of Preferences, Ethical Framing, and Meaning-Making.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
End-of-life decision-making in intensive care units (ICUs) is a complex and ethically challenging process shaped not only by clinical factors but also by patients' values, cultural contexts, and spiritual or religious beliefs. Although spirituality and religiosity are increasingly recognized as influential in decisions regarding life-sustaining treatment, their role has not been comprehensively synthesized within ICU settings. This systematic review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, examined the influence of spirituality and religiosity on end-of-life decision-making among adult ICU patients, surrogate decision-makers, and healthcare professionals. Electronic searches of PubMed/MEDLINE, Scopus, and Web of Science identified eligible quantitative, qualitative, and mixed-methods studies, and findings were synthesized narratively because of methodological heterogeneity. Eight studies met the inclusion criteria. Overall, higher levels of religiosity were consistently associated with a stronger preference for aggressive life-prolonging interventions and a lower likelihood of treatment limitation. Spiritual and religious beliefs also influenced clinicians' ethical perspectives, particularly regarding the distinction between withholding and withdrawing life-sustaining treatments, while playing a central role in surrogate decision-making by shaping interpretations of illness, hope, and acceptable care. At the same time, spirituality demonstrated a multidimensional role, facilitating acceptance of death, promoting support for palliative care in some contexts, and contributing to meaning-making during the end-of-life process. Cultural and contextual factors moderated these relationships, and the provision of spiritual care by healthcare professionals was associated with less aggressive end-of-life care. These findings indicate that spirituality and religiosity exert a substantial yet context-dependent influence on end-of-life decision-making in ICUs. Integrating spiritual assessment and culturally sensitive spiritual care into routine clinical practice may enhance shared decision-making and improve alignment between treatment decisions and patients' values, preferences, and goals of care.
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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.