Annual Report from the Ethics Section (2013)
Chair: Jozef Kesecioglu, Utrecht, Netherlands,
Deputy: Andrej Michalsen, Tettnang, Germany,
In 2013, the Ethics section has continued to develop research activities and to work in the congress committee with the other sections by proposing original sessions for the next annual congress in Paris. As is known from previous years, Elie Azoulay and Jozef Kesecioglu were representing the society to share the ATS project entitled "Statement on futility and goal conflict in end-of-life care in ICUs".The drafted statementhas been circulating within tenors of ethical issues in the US and Canada. At this moment there is a near final draft of the document prepared by the writing committee, which will shortly be distributed to the larger group for comment. This statement makes reference issues such as the definition of futility, patient's-physicians relationship, guidelines, end-of-life preferences and the importance of autonomy in this context. Initially, the group did not intend to produce a statement that would be valid elsewhere than in North America. Concerns were stated on that point and some revisions were suggested. Recently, the chairs of the ATS statement have indicated their wish to change this ATS-only statement into a joint ATS, SCCM, ACCP, AACN, and ESICM statement. This is considered to be a good development.
Over the last years, the section has performed studies such as Ethicus, Ethicatt, Eldicus, Conflicus, and APPROPRICUS. In 2013, there wasa new articleaccepted for publication from the Eldicus (Charles Sprung) studies. The first manuscript of the study EuroPain, on procedural pain, led by Kathleen Puntillo (Established Investigator Award) is under review at a journal, and other publications are being planned.A study performed on Clinical Features and Outcomes of Lung Cancer Patients Admitted to ICUs in Latin America and Europe by Marcio Soares and Jorge Salluh, Elie Azolay and Jean-Francois Timsit has recently been completed. Around 500 patients from 22 ICUs from Argentina, Brazil, Chile, France, UK, and Uruguay are included. The manuscript is under preparation and preliminary results will be presented in the next ESICM Congress.Charles Sprung is writing the manuscripts for the project Consensus Guidelines for Worldwide End of Life Practice for Patients in Intensive Care Units (Welpicus) and along with Phillip Levin another paper on Multiresistant Bacteria and End of Life Decisions.The PALLICUS study led by Elie Azoulayis investigating palliative NIV as the ceiling of therapy in critically ill patients. Dominique Benoit will start with the DISPROPRICUS study (formerly APPRPRICUSE) in March 2014. The study is on schedule and a meeting will be planned in October in Paris with all national coordinators and some local investigators.Rik Gerritsen is working on a European modificationof the QODD questionnaire on quality of end of life in ICU.Victoria Metaxa has performed an observational study on end-of-life and admission triage decisions in Hellenic ICUs.The data collection is now complete and a draft manuscript for publication is being prepared.
The 2013 annual meeting in Paris will mark another successful year for our section. Planned sessions will address various ethical issues in research and patient care. As usual, we also have several joint sessions with other sections. Finally, abstracts that have been accepted for the Paris conference will be presented in several sessions.
Last but not least, 2013 was an election year for our section. Andrej Michalsen (Tettnang, Germany) has been elected as the new Chair and Rik Gerritsen (Leeuwarden, Netherlands) as the Deputy. Their term of three years will start during the ESICM symposium in Paris.