--- title: "Decision aids for life-sustaining treatment and end-of-life care in emergency and intensive care:" id: "bmj-open-9-decision-aids-for-life-sustaining-treatment-including-withholding-or-withdrawal" canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-9-decision-aids-for-life-sustaining-treatment-including-withholding-or-withdrawal" content_type: "clinical_feed_article" specialty: "Critical Care" source_name: "BMJ Open" source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e124454?rss=1" published_at: "2026-09-04T11:29:48.000Z" evidence_level: "Journal Feed" license: "CC-BY-NC-4.0 / Informational Use" --- # Decision aids for life-sustaining treatment and end-of-life care in emergency and intensive care: ## Provenance & Clinical Metadata - **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-9-decision-aids-for-life-sustaining-treatment-including-withholding-or-withdrawal - **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md) - **Primary Source:** BMJ Open - **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e124454?rss=1) - **Published At:** 2026-09-04T11:29:48.000Z - **Evidence Rating:** Journal Feed ## Executive GIST (TL;DR) - This protocol outlines a scoping review to identify and map literature on **decision aids** and related interventions that support **shared decision-making (SDM)** about **life-sustaining treatment** and end-of-life care in **emergency** and **intensive care** settings. - The review responds to ethical and emotional complexity in these settings, including prognostic uncertainty, limited time for deliberation, and frequent patient incapacity requiring surrogate decision-makers. - The authors note decision aids are evidence-based tools presenting options, benefits and harms, and supporting values clarification, but their use in acute care for life-sustaining and end-of-life decisions is fragmented and not comprehensively mapped. - The scoping review will follow the **Joanna Briggs Institute (JBI)** methodology and will be reported using **PRISMA-ScR**. - Databases searched will include PubMed, Web of Science, CENTRAL, CINAHL and Ichushi-Web; eligible studies are those published in English or Japanese from January 2000 onward. - Included study designs: quantitative, qualitative, mixed-methods and descriptive studies that address decision aids or related interventions for adult patients, family members, surrogate decision-makers or healthcare professionals in emergency and intensive care settings. - Two reviewers will independently screen, assess eligibility and chart data. - Data synthesis will be descriptive and presented in narrative and tabular formats. - No ethics approval is required because only publicly available literature will be analyzed. - Planned dissemination includes publication in a peer-reviewed journal and presentation at scientific conferences. ## Clinical Analysis & Structured Key Points Introduction Decisions regarding life-sustaining treatment and end-of-life care are among the most ethically complex and emotionally challenging decisions encountered in emergency departments and intensive care units. Such decisions frequently involve uncertainty regarding prognosis, limited time for deliberation and situations in which patients may lack decision-making capacity, requiring family members or surrogate decision-makers to participate in the decision-making process. Shared decision-making (SDM) has increasingly been recommended as an approach to align treatment decisions with patients' values and preferences. Decision aids are evidence-based tools designed to support informed and value-congruent healthcare decisions by presenting available options, potential benefits and harms and opportunities for values clarification. Although decision aids have been extensively studied in chronic disease management and preference-sensitive healthcare decisions, their use in life-sustaining treatment and end-of-life care in emergency and intensive care settings remains fragmented and has not yet been comprehensively mapped. This scoping review aims to identify and map the existing literature on decision aids and related interventions that support SDM for life-sustaining treatment and end-of-life care in emergency and intensive care settings. Methods and analysis This scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Electronic searches will be performed in PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and Ichushi-Web. Studies published in English or Japanese from January 2000 onwards will be eligible. Quantitative, qualitative, mixed-methods and descriptive studies addressing decision aids or related interventions designed to support SDM regarding life-sustaining treatment and end-of-life care among adult patients, family members, surrogate decision-makers or healthcare professionals in emergency and intensive care settings will be included. Two reviewers will independently screen studies, assess eligibility and chart data. Findings will be synthesised descriptively and presented in narrative and tabular formats. Ethics and dissemination Ethics approval is not required because this review will analyse data from publicly available literature and will not involve human participants. 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