Withdrawal of mechanical ventilation in amyotrophic lateral sclerosis patients: a multicenter Italian survey
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Law 219/2017 was approved in Italy in December 2017, after a years-long debate on the autonomy of healthcare choices. This Law, for the first time in Italian legislation, guarantees the patient's right to request for withdrawal of life-sustaining treatments, including mechanical ventilation (MV). OBJECTIVE: To investigate the current status of MV withdrawal in amyotrophic lateral sclerosis (ALS) patients in Italy and to assess the impact of Law 219/2017 on this practice. METHODS: We conducted a Web-based survey, addressed to Italian neurologists with expertise in ALS care, and members of the Motor Neuron Disease Study Group of the Italian Society of Neurology. RESULTS: Out of 40 ALS Italian centers, 34 (85.0%) responded to the survey. Law 219/2017 was followed by an increasing trend in MV withdrawals, and a significant increase of neurologists involved in this procedure (p 0.004). However, variations across Italian ALS centers were observed, regarding the inconsistent involvement of community health services and palliative care (PC) services, and the intervention and composition of the multidisciplinary team. CONCLUSIONS: Law 219/2017 has had a positive impact on the practice of MV withdrawal in ALS patients in Italy. The recent growing public attention on end-of-life care choices, along with the cultural and social changes in Italy, requires further regulatory frameworks that strengthen tools for self-determination, increased investment of resources in community and PC health services, and practical recommendations and guidelines for health workers involved.
Source: Neurological Sciences
Authors: Cristina Moglia, Francesca Palumbo, Simone Veronese, M. N. D. Italian Study Group, Stefania Angelocola, Paolo Barone, Ilaria Bartolomei, Enrica Bersano, Alessandro Bombaci, Giuseppe Borghero, Sara Cabras, Chiara Cambieri, Elena Canali, Antonio Canosa, Margherita Capasso, Claudia Caponnetto, Patrizio Cardinali, Mario Casmiro, Marco Ceccanti, Adriano Chiò, Monica Consonni, Eleonora Dalla Bella, Fabiola De Marchi, Filippo De Mattei, Eustachio D’Errico, Francesca Di Pede, Luca Diamanti, Raffaele Dubbioso, Massimo Filippi, Massimiliano Filosto, Nicola Fini, Giulia Gianferrari, Maurizio Grassano, Maurizio Inghilleri, Vincenzo La Bella, Giuseppe Lauria Pinter, Laura Libonati, Francesco Logullo, Jessica Mandrioli, Umberto Manera, Ilaria Martinelli, Gioacchino Martusciello, Sabrina Matà, Enrico Matteoni, Letizia Mazzini, Doriana Medici, Stefania Miniello, Federica Moret, Cecilia Nozzoli, Giovanni Piccirillo, Giovanna Pilurzi, Nilo Riva, Silvia Romito, Massimo Russo, Fabrizio Salvi, Elisabetta Sette, Vincenzo Silani, Isabella Laura Simone, Cecilia Simonini, Rossella Spataro, Giovanna Squintani, Salvatore Stano, Raffaella Tanel, Gioacchino Tedeschi, Nicola Ticozzi, Antonella Toriello, Lucio Tremolizzo, Francesca Trojsi, Veria Vacchiano, Rosario Vasta, Paolo Volanti, Lucia Zinno, Elisabetta Zucchi, Andrea Calvo
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,690
Awards: G1183686639, G1184370674, G1707306367, Deconstruct and rebuild phenotypes: a multimodal approach toward personalized medicine in ALS (DECIPHER-ALS), G3178720459, G3207356259, G393177772, G434337789, G4842425482, BRinging Artificial INTelligencE home for a better cAre of amyotrophic lateral sclerosis and multiple SclERosis, G569774987, G5702163051, G581753051, G63770550, G7209824943, G7697237310, G7998118070, European multidisciplinary ALS network identification to cure motor neuron degeneration
OpenAlex ID: W4383481657