{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T17:51:50Z","timestamp":1775325110151,"version":"3.50.1"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T00:00:00Z","timestamp":1412121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Great differences in end-of-life practices in treating the critically ill around the world warrant agreement regarding the major ethical principles. This analysis determines the extent of worldwide consensus for end-of-life practices, delineates where there is and is not consensus, and analyzes reasons for lack of consensus. Critical care societies worldwide were invited to participate. Country coordinators were identified and draft statements were developed for major end-of-life issues and translated into six languages. Multidisciplinary responses using a web-based survey assessed agreement or disagreement with definitions and statements linked to anonymous demographic information. Consensus was prospectively defined as &amp;gt;80% agreement. Definitions and statements not obtaining consensus were revised based on comments of respondents, and then translated and redistributed. Of the initial 1,283 responses from 32 countries, consensus was found for 66 (81%) of the 81 definitions and statements; 26 (32%) had &amp;gt;90% agreement. With 83 additional responses to the original questionnaire (1,366 total) and 604 responses to the revised statements, consensus could be obtained for another 11 of the 15 statements. Consensus was obtained for informed consent, withholding and withdrawing life-sustaining treatment, legal requirements, intensive care unit therapies, cardiopulmonary resuscitation, shared decision making, medical and nursing consensus, brain death, and palliative care. Consensus was obtained for 77 of 81 (95%) statements. Worldwide consensus could be developed for the majority of definitions and statements about end-of-life practices. Statements achieving consensus provide standards of practice for end-of-life care; statements without consensus identify important areas for future research.<\/jats:p>","DOI":"10.1164\/rccm.201403-0593cc","type":"journal-article","created":{"date-parts":[[2014,8,27]],"date-time":"2014-08-27T15:03:15Z","timestamp":1409151795000},"page":"855-866","source":"Crossref","is-referenced-by-count":199,"title":["Seeking Worldwide Professional Consensus on the Principles of End-of-Life Care for the Critically Ill. The Consensus for Worldwide End-of-Life Practice for Patients in Intensive Care Units (WELPICUS) Study"],"prefix":"10.1093","volume":"190","author":[{"given":"Charles L.","family":"Sprung","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel"}]},{"given":"Robert D.","family":"Truog","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Children\u2019s Hospital, Boston, Massachusetts"}]},{"given":"J. Randall","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Harborview Medical Center and The University of Washington, Seattle, Washington"}]},{"given":"Gavin M.","family":"Joynt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong"}]},{"given":"Mario","family":"Baras","sequence":"additional","affiliation":[{"name":"The Hebrew University\u2013Hadassah School of Public Health, Hadassah Medical Center, Jerusalem, Israel"}]},{"given":"Andrej","family":"Michalsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care Medicine, Tettnang Hospital, Tettnang, Germany"}]},{"given":"Josef","family":"Briegel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Munich, Germany"}]},{"given":"Jozef","family":"Kesecioglu","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands"}]},{"given":"Linda","family":"Efferen","sequence":"additional","affiliation":[{"name":"Department of Medicine, South Nassau Communities Hospital, Oceanside, New York"}]},{"given":"Edoardo","family":"De Robertis","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples, Federico II, Naples, Italy"}]},{"given":"Pierre","family":"Bulpa","sequence":"additional","affiliation":[{"name":"Intensive Care Unit of Centre Hospitalier Universitaire Dinant-Godinne, Universit\u00e9 Catholique de Louvain, Yvoir, Belgium"}]},{"given":"Philipp","family":"Metnitz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and General Intensive Care, University Hospital of Vienna, Vienna, Austria"}]},{"given":"Namrata","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Thoracic Surgery and Division of Trauma, Burn and Critical Care, Brigham & Women\u2019s Hospital, Boston, Massachusetts"}]},{"given":"Laura","family":"Hawryluck","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Toronto Western Hospital, Toronto, Ontario, Canada"}]},{"given":"Constantine","family":"Manthous","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, Lawrence and Memorial Hospital, New London, Connecticut"}]},{"given":"Rui","family":"Moreno","sequence":"additional","affiliation":[{"name":"Unidade de Cuidados Intensivos Neurocr\u00edticos, Hospital de Sao Jose, Centro Hospitalar de Lisboa Central, E.P.E., Lisbon, Portugal"}]},{"given":"Sara","family":"Leonard","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, King\u2019s College Hospital, London, United Kingdom"}]},{"given":"Nicholas S.","family":"Hill","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care Division, Tufts Medical Center, Boston, Massachusetts"}]},{"given":"Elisabet","family":"Wennberg","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden"}]},{"given":"Robert C.","family":"McDermid","sequence":"additional","affiliation":[{"name":"Division of Critical Care, University of Alberta, Edmonton, Alberta, Canada"}]},{"given":"Adam","family":"Mikstacki","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Therapy, Regional Hospital, Pozna\u0144, Poland"}]},{"given":"Richard A.","family":"Mularski","sequence":"additional","affiliation":[{"name":"the Center for Health Research Kaiser Permanente Northwest, Portland, Oregon; 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