End-of-life Care in the ICU: Commonalities and Differences between North America and Europe

Advances in medical science and health care have gradually changed the nature of dying. Death no longer is likely to be the sudden result of infection or injury, but instead occurs slowly, in old age, and at the end of a period of life-limiting or chronic illness. This shift has created new challenges for critical care medicine. In this chapter, we provide a brief overview about critical care utilization at the end-of-life and the most important challenges we face. We discuss these challenges from an American and European perspective, as end-of-life decisions vary substantially between these two continents.