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Decision aids for life-sustaining treatment, including withholding or withdrawal and end-of-life care in emergency and intensive care settings: a scoping review protocol.

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Title: Decision aids for life-sustaining treatment, including withholding or withdrawal and end-of-life care in emergency and intensive care settings: a scoping review protocol.
Authors: Tsubaki M; School of Nursing, Kitasato University, Sagamihara, Japan michi.t7@nrs.kitasato-u.ac.jp., Saito K; School of Nursing, Kitasato University, Sagamihara, Japan., Kanayasu H; School of Nursing, Kitasato University, Sagamihara, Japan., Ikari R; Department of Emergency Nursing, Kitasato University Hospital, Sagamihara, Japan., Yamamoto K; Department of Emergency Nursing, Kitasato University Hospital, Sagamihara, Japan., Yamane A; Department of Emergency Nursing, Kitasato University Hospital, Sagamihara, Japan., Ito Y; Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan.
Source: BMJ open [BMJ Open] 2026 Sep 04; Vol. 16 (9), pp. e124454. Date of Electronic Publication: 2026 Sep 04.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
Imprint Name(s): Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms: Terminal Care*/ethics , Withholding Treatment*/ethics , Decision Support Techniques* , Decision Making, Shared* , Critical Care* , Life Support Care*, Humans ; Scoping Reviews as Topic ; Decision Making ; Intensive Care Units ; Research Design ; Emergency Service, Hospital
Abstract: 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. Findings will be disseminated through publication in a peer-reviewed journal and presentation at relevant scientific conferences.
(© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)
Competing Interests: Competing interests: None declared.
References: BMC Med Inform Decis Mak. 2013;13 Suppl 2:S1. (PMID: 24624947)
Intensive Crit Care Nurs. 2025 Aug;89:104055. (PMID: 40306072)
Int J Evid Based Healthc. 2015 Sep;13(3):141-6. (PMID: 26134548)
Psychooncology. 2022 Sep;31(9):1502-1509. (PMID: 35793436)
Cochrane Database Syst Rev. 2020 Feb 27;2:CD013022. (PMID: 32104908)
J Gen Intern Med. 2012 Oct;27(10):1361-7. (PMID: 22618581)
Worldviews Evid Based Nurs. 2016 Apr;13(2):118-23. (PMID: 26821833)
Crit Care. 2024 Nov 11;28(1):362. (PMID: 39529154)
Cochrane Database Syst Rev. 2017 Oct 03;10:CD012330. (PMID: 28972652)
J Crit Care. 2016 Apr;32:79-84. (PMID: 26810482)
Clin Case Rep. 2025 Jan 07;13(1):e9703. (PMID: 39780906)
Cochrane Database Syst Rev. 2017 Apr 12;4:CD001431. (PMID: 28402085)
Cochrane Database Syst Rev. 2010 May 12;(5):CD006732. (PMID: 20464744)
Emerg Med Australas. 2016 Dec;28(6):684-690. (PMID: 27701845)
BMJ Open. 2019 Mar 23;9(3):e026701. (PMID: 30904876)
JBI Evid Synth. 2020 Oct;18(10):2119-2126. (PMID: 33038124)
Ann Am Thorac Soc. 2015 Oct;12(10):1528-33. (PMID: 26240996)
Jpn J Nurs Sci. 2022 Jan;19(1):e12451. (PMID: 34490984)
J Clin Ethics. 2026 Summer;37(2):180-182. (PMID: 42127797)
Med Decis Making. 2021 Oct;41(7):729-733. (PMID: 34416841)
Cureus. 2025 Apr 16;17(4):e82403. (PMID: 40385767)
J Relig Health. 2016 Oct;55(5):1596-606. (PMID: 26725047)
J Clin Ethics. 2014 Spring;25(1):13-9. (PMID: 24779313)
J Gen Intern Med. 2022 Sep;37(12):2966-2972. (PMID: 35037173)
Nurs Crit Care. 2025 May;30(3):e13171. (PMID: 39411836)
Ann Intern Med. 2018 Oct 2;169(7):467-473. (PMID: 30178033)
Nurs Crit Care. 2019 Jul;24(4):209-221. (PMID: 31210390)
Soc Sci Med. 2010 Feb;70(4):616-22. (PMID: 19932548)
Health Expect. 2021 Aug;24(4):1178-1186. (PMID: 33991160)
Cochrane Database Syst Rev. 2024 Jan 29;1:CD001431. (PMID: 38284415)
BMC Med Inform Decis Mak. 2025 Feb 07;25(1):65. (PMID: 39920721)
J Clin Nurs. 2019 Aug;28(15-16):2790-2800. (PMID: 29752844)
Death Stud. 2025;49(3):300-311. (PMID: 38459868)
BMJ. 2026 Jun 12;393:e088116. (PMID: 42285563)
Nurs Crit Care. 2014 May;19(3):135-44. (PMID: 24118629)
Contributed Indexing: Keywords: Adult intensive & critical care; Clinical Decision-Making; Decision Making, Shared; Emergency Service, Hospital; Review
Entry Date(s): Date Created: 20260904 Date Completed: 20260904 Latest Revision: 20260912
Update Code: 20260912
PubMed Central ID: PMC13560963
DOI: 10.1136/bmjopen-2026-124454
PMID: 42697572
Database: MEDLINE
Description
ISSN:2044-6055
DOI:10.1136/bmjopen-2026-124454