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Table 1 Relationship between systematic review classification and original studies

From: International changes in end-of-life practices over time: a systematic review

Figure number

Systematic review classification

Example of labelling and definitions used in original study

2

Witholding or withdrawal of treatment with the potential to prolong life

« Non-treatment decisions »: the withholding or withdrawal of treatment in situations where the treatment would probably have prolonged life [24]; withhold or withdraw medical treatment while taking into account the possibility or certainty that this would hasten the patient’s death or with the explicit intention of hastening the patient’s death [31]; withheld or withdrawn medical treatment while taking into account the possible hastening of death (only for cases in which there was no single most explicit intention, the administration of drugs prevailed over the withholding or withdrawing of treatment) [36]. Note : Inconsistently report whether drugs were administered with or without patient voluntary request.

3

Use of opiates with possible life-shortening effects

« Alleviation of pain and symptoms » : alleviation of pain and symptoms with opioids in such dosages that the patient’s life might have been shortened [24]; intensify the alleviation of pain and suffering while taking into account the possibility or certainty that this would hasten the patient’s death or partly with the intention of hastening the patient’s death [31]. Note : includes cases where opioids were used with the intention to hasten death. Inconsistently report whether drugs were administered with or without patient voluntary request.

4

Use of sedatives with possible life-shortening effects

« Continuous deep sedation »: deeply and continuously sedated until death [36]; the patient receive drugs, such as barbiturates or benzodiazepines, to keep him/her continuously in deep sedation or coma until death [26]. Note : does not distinguish whether sedatives were used with or without the intention to hasten death. Inconsistently report whether drugs were administered with or without patient voluntary request.

5

Intentional use of lethal drugs self-administered by patients

« Assisted suicide »: the prescription or supply of drugs by a physician with the explicit intention of shortening life, when the drug is administered by patients [24, 31]. Note : does not include the use of drugs with the « partial » intention to cause death.

6

Intentional use of lethal drugs administered by professionals with patient request

« Euthanasia »: the prescription, supply or administration of drugs with the explicit intention of shortening life, when the dru gis administered by professionals [24]; death as the result of the administration, supply, or prescription of drugs with the explicit intention of hastening the patient’s death (administered by professionals) [31]. Note : does not include the use of drugs with the « partial » intention to cause death.

7

Intentional use of lethal drugs administered by professionals without patient request

« Termination of life without a patient request »: the prescription, supply or administration of drugs with the explicit intention of shortening life (without patient explicit request) [24]; death as the result of the administration, supply, or prescription of drugs with the explicit intention of hastening the patient’s death (without patient explicit request) [31]. Note : does not include the use of drugs with the « partial » intention to cause death.