1. Ethical attitudes and perspectives of AI use in medicine between Croatian and Slovenian faculty members of school of medicine : cross-sectional studyŠtefan Grosek, Stjepan Štivić, Ana Borovečki, Marko Ćurković, Jaro Lajovic, Ana Marušić, Antonija Mijatović, Mirjana Miksić, Suzana Mimica Matanović, Eva Škrlep, Kristina Lah Tomulić, Vanja Erčulj, 2024, izvirni znanstveni članek Ključne besede: artificial intelligence, AI, ethical attitudes, medicine
Objavljeno v DiRROS: 01.07.2026; Ogledov: 284; Prenosov: 185
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2. Navigating the shadows : medical professionals' values and perspectives on end-of-life care within pediatric intensive care units in CroatiaMarko Ćurković, Filip Rubic, Ana Jozepovic, Milivoj Novak, Boris Filipović-Grčić, Julije Meštrović, Kristina Lah Tomulić, Branimir Peter, Diana Špoljar, Štefan Grosek, 2024, izvirni znanstveni članek Povzetek: Background and aim: This study explores healthcare professionals' perspectives on end-of-life care in pediatric intensive care units (ICUs) in Croatia, aiming to illuminate their experiences with such practices, underlying attitudes, and major decision-making considerations. Amid the high variability, complexity, and emotional intensity of pediatric end-of-life decisions and practices, understanding these perspectives is crucial for improving care and policies. Methods: The study utilized a cross-sectional survey intended for physicians and nurses across all pediatric ICUs in Croatia. It included healthcare professionals from six neonatal and four pediatric ICUs in total. As the data from neonatal and pediatric ICUs were examined jointly, the term pediatric ICU was used to denominate both types of ICUs. A statistical analysis was performed using Python and JASP, focusing on professional roles, professional experience, and regional differences. Results: The study included a total of 103 participants (with an overall response rate-in relation to the whole target population-of 48% for physicians and 29% for nurses). The survey revealed diverse attitudes toward and experiences with various aspects of end-of-life care, with a significant portion of healthcare professionals indicating infrequent involvement in life-sustaining treatment (LST) limitation discussions and decisions, as well as somewhat ambiguous attitudes regarding such practices. Notably, discrepancies emerged between different professional roles and, in particular, regions, underscoring the high variability of LST limitation-related procedures. Conclusions: The findings highlight a pressing need for more straightforward guidelines, legal frameworks, support mechanisms, and communication strategies to navigate the complex terrain of rather burdensome end-of-life pediatric care, which is intrinsically loaded with profound ethical quandaries.
Ključne besede: end of life, ethics, healthcare professionals, intensive care, intensive care units, pediatrics, withdrawing, withholding
Objavljeno v DiRROS: 08.06.2026; Ogledov: 458; Prenosov: 192
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3. Ethics and end-of-life in pediatric and neonatal ICUs : a systematic review of recommendationsDiana Špoljar, Sunčana Janković, Dina Vrkić, Geraldine McNamara, Marko Ćurković, Milivoj Novak, Boris Filipović-Grčić, Štefan Grosek, Chris Gastmans, Bert Gordijn, 2025, izvirni znanstveni članek Povzetek: Background: Working in neonatal intensive care units (NICUs) or pediatric intensive care units (PICUs) entails making difficult decisions about children at the end of their lives that raise significant ethical issues. This review identified the ethical content of the papers containing expert guidelines and recommendations in relation to end-of-life decision-making in NICUs and PICUs, by analyzing ethical positions and ethical principles behind them. Methods: Systematic search was limited to the period from 1990 to 2023 and encompassed 6 bibliographic databases (Medline, PubMed, CINAHL, APA PsycINFO, Web of Science Core Collection, and Scopus), grey literature sources and relevant reference lists. The international, national, or institutional papers providing expert guidelines and recommendations comprehensively addressing either withholding/withdrawing of life sustaining treatment, palliative care, and/or intentional life terminating actions in NICUs and PICUs were included in analysis. Also, only papers published in English language were considered. Papers that were not developed by intensive care expert communities and those that were either too narrow (e.g., dealing with specific issues or specific patient groups) or broad (e.g., addressing issues of interest on general and abstract level) were excluded. The search data were gathered and deduplicated, partly by Mendeley software. Titles and abstracts were screened by three independent reviewers, and full-text papers further reviewed and assessed for eligibility. Subsequently, data of interest were extracted, and qualitative analysis was performed. Results: Initial search retrieved 6784 papers from bibliographic databases and 363 from other utilized sources. Titles and abstracts from 2827 papers were screened. 17 full texts were further assessed resulting in a total number of 9 papers (6 from bibliographic databases and 3 from other sources) which met the inclusion criteria and were included for analysis. The papers were published from 2001 to 2021. Four papers primarily focus on NICU setting, while five on PICU. A total of 38 ethical positions were identified and were grouped under 5 themes according to the content of the positions, relating to: patients, parents, medical team, decision-making and treatment options. A total of 12 ethical principles were mentioned in the papers. The principle of beneficence emerged as the most prominent one. It was explicitly mentioned in all included papers except one. Conclusions: This review has shown that papers containing guidelines and recommendations on end-of-life decision-making in the NICU and PICU promote similar stances. The ethical principle of beneficence is at the core of the decision-making process, and all decisions are made focusing on the child's best interests.
Ključne besede: decision-making, end-of-life, ethics, NICU, PICU
Objavljeno v DiRROS: 26.02.2026; Ogledov: 508; Prenosov: 290
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