Evaluating our end-of-life practice

Ferrand et al's recent study of withholding and withdrawing life support in intensive care units in France reminds us that reporting end-of-life practices is an important step towards enhancing end-of-life care. The study highlights differences between the paternalistic approach to decision making in Europe, and the patient autonomy model in the USA. However, the reasons intensivists report for withholding or withdrawing life support are similar in both cultures. Intensivists in France make decisions despite a lack of formal guidelines in their country. This study should serve as a stimulus for educating the public and motivating more groups to monitor their end-of-life practices.