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We present an experimental investigation of the role of resumptive pronouns. We investigate object extraction in WH-questions for a range of syntactic configurations (nonislands, weak islands, strong islands) and for multiple levels of embedding (single, double, and triple). In order to establish the crosslinguistic properties of resumption, parallel experiments were conducted in three languages, viz. English, Greek, and German. Three main experimental results are reported. First, resumption does not remedy island violations: resumptive pronominals are at most as acceptable as gaps, but not more acceptable. This result disconfirms claims in the literature that resumptives can ‘save’ island violations. Second, embedding reduces acceptability even in extraction out of nonislands and declaratives, structures standardly assumed to be fully grammatical. Third, nonislands and weak islands pattern together and contrast with strong islands in terms of the effect of resumption and embedding. Our experimental findings show a remarkable consistency across the three languages we investigate; crosslinguistic variation appears confined to quantitative differences in crosslinguistically identical principles. We argue that these experimental results can be explained by the interaction of grammatical principles with resource limitations of the human parser. In particular, extraction from nonislands and weak islands imposes increased demands on the computational resources of the parser. We extend Gibson's (1998) syntactic prediction locality theory in order to formalize this intuition and account for the processing complexity of A-bar dependencies.
Withholding or withdrawing life-sustaining therapies (WLST) was introduced in France in 2005 through the Leonetti law to prevent futile treatments and “unreasonable obstinacy.” In France, WLST decisions affect 8.5–14% of ICU patients, according to the literature. The 2016 Claeys–Leonetti law updated the previous legislation, but debates surrounding end-of-life care persist.
Methods
To describe WLST patients and practices under current legislation, we conducted a multicenter, prospective, observational study in ICUs across Eastern France. Eligible adult patients facing WLST decisions were included, requiring written consent from the patient or a trusted person. Patients were followed for 1 month. We described the decision-making process and assessed family satisfaction using the FS-24R-ICU questionnaire.
Results
Between May 3rd and October 3rd, 2023, 73 patients were included (mean age 69 years). The majority of admissions were medical (72.7%), and 50.7% of patients had neurological impairments. ICU staff initiated WLST discussions primarily due to poor survival or quality of life prospects. Only 12.5% of patients had written advance directives, and 59.1% had designated a trusted person. External consultation was not involved in 19.1% of decisions. Families were informed in 91.7% of cases. Decisions to withhold therapies occurred in 68.1% of cases, with resuscitation during cardiac arrest being the most commonly withheld intervention (98.0%). Treatment withdrawal occurred in 31.9% of cases. Family satisfaction was generally positive.
Conclusions
WLST management in Eastern French ICUs is partially compliant with the Claeys–Leonetti law. Improved law application and public awareness could enhance end-of-life care management in France.