Age, comorbidity and functional status influence end-of-life decisions in critical illness, while nationality, ethnicity and clinician experience influence the agressiveness of medical care.

Context Despite the intense use of technology and aggressive medical care, intensive care units are common places of EOL decision-making and death.1–3 Most critically ill patients are unable to participate in EOL decision-making due to the severity of their illness or need for sedation. In an effort to respect the ethical principle of autonomy, healthcare professionals engage the patient’s family in the EOL decision-making.4 5 Although there is a growing body of literature on EOL decision-making during critical illness, there has been limited synthesis of these fi ndings to guide clinical practice and research. The systematic review (SR) conducted by Frost et al identifi es several factors associated with patients and healthcare professionals that infl uence EOL decision-making.