Ethics
The Ethics section is led by Victoria Metaxa.
Ethics News
WhatsApp Community
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RESOURCES
Explore the ESICM storytelling for actionable strategies to implement the 3R (Recognise, Reverse, Resilience) approach and combat burnout. Together, We Are Intensive Care!

Education
Courses
Clinical Ethics and End-of-Life Care
Webinars & Podcasts
Webinars
– Human factors in critical care
– Caring for a potential organ donor in ICU
– Voices of ICU survivors: An ESICM-SCCM initiative
– SICU Staff WellBeing: an ESICM priority
– Transforming patient pathway – kick off webinar
Podcasts
– Ethical Issues in the ICU
– Burned out in ICU professionals
– European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit
– A randomised controlled trial of a nurse facilitator to promote communication for family members of critically ill patients
– End of Life Care concepts in intensive care (NEXT/N&AHP)
Free webinars and podcasts are available for members & non members on LIVES-STREAM.
Use your ESICM credentials or create an account
Research
Projects
Human-Centred Partnership Project – Jos Latour, Margo van Mol, Emilio Rodriguez-Ruiz, Jozef Kesecioglu
The aim of the proposed project is to develop a consensus statement on human-centred partnership in ICU. The scope of the consensus statement will include (but is not limited to): Person-Centred Care; Communication and Transparency; Emotional Well-being; Equality, Diversity, Inclusion; ICU Environment; Technology and Innovation
Residents and Fellows in Icu Ethics Survey (ReFInES) – Emilio Rodriguez-Ruiz, Jos Latour, Victoria Metaxa
ER presented the project aiming to explore experiences and perceptions of ethical dilemmas from the perspective of residents and fellows and what is offered in terms of ethics education as part of their training. Explore the gaps in education. Identify what could be improved.
End-of-Life Practices in LMIC Intensive Care Units: The EoLMICs Multinational Study – Mohamed Boussarsar, Radhouane Toumi, Victoria Metaxa
The group aims to identify, share, and implement best practices, foster collaborative efforts, and drive continuous improvement in patient care approaching end of life. Its focus includes (but is not exhaustive of) symptom management; communication, patient-centred care; palliative care in ICU; decision-making; interprofessional collaboration; conflict prevention.
Guidelines and consensus statement
2025
Beil, M., Alberto, L., Bourne, R.S. et al. ESICM consensus-based recommendations for the management of very old patients in intensive care. Intensive Care Med 51, 287–301 (2025). https://doi.org/10.1007/s00134-025-07794-4 . Intensive Care Med (2025). Volume 51, pages 287–301, (2025). Published online on 17 February 2025.
2024
Kesecioglu, J., Rusinova, K., Alampi, D. et al. European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit. Intensive Care Med 50, 1740–1766 (2024). https://doi.org/10.1007/s00134-024-07579-1 Published in open access.
Demoule, A., Decavele, M., Antonelli, M. et al. Dyspnoea in acutely ill mechanically ventilated adult patients: an ERS/ESICM statement. Intensive Care Med 50, 159–180 (2024). https://doi.org/10.1007/s00134-023-07246-x. Published on 22 February 2024.
Relevant Literature
– Kesecioglu, J., Rusinova, K., Alampi, D. et al. European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit. Intensive Care Med 50, 1740–1766 (2024).
– Brown, C., Hartley, P., Forsyth, F. et al. What measures have been used to explore the outcomes of family members of critically ill patients: a scoping review. Intensive Care Med 51, 1641–1650 (2025).
– Rowland, A., Boulanger, C. & Dalton, L. Supporting the bereaved child in the adult ICU: a narrative review. Intensive Care Med 51, 570–581 (2025).
– Porter, L.L., Simons, K.S., van der Hoeven, J.G. et al. Discussing expected long-term quality of life in the ICU: effect on experiences and outcomes of patients, family, and clinicians—a randomized clinical trial. Intensive Care Med 51, 478–489 (2025).
– Siddiqui, S., Metaxa, V. Cultivating cultural competence in ICU communication. Intensive Care Med 51, 599–602 (2025).
– de Souza, J.M.B., Miozzo, A.P., da Rosa Minho dos Santos, R. et al. Long-term effects of flexible visitation in the intensive care unit on family members’ mental health: 12-month results from a randomized clinical trial. Intensive Care Med 50, 1614–1621 (2024).
Article Reviews
– Improving decision-making with family members of nursing home residents
Dementia is a common disease in old age and most of the patients with late-stage dementia both reside and die in nursing homes.
– Burnout Syndrome in Critical Care: A Call for Action
Burnout syndrome is triggered by a discrepancy between the expectations and ideals of the employee and the actual requirements of his position.
– Withholding and withdrawal of life-sustaining treatments: Examining the socioeconomic factors
– Decisions to withhold or withdraw life-sustaining treatment: Is there global variability?