[Ethical considerations in pediatric intensive therapy]

The author presents some ethical aspects of the decisions taken in pediatric intensive care units (PICU), and discusses the indications for the care of terminally-ill children. Assessment of the patient based on the clinical knowledge and experience of the pediatrician-intensivist must come first, well before the evaluation using various systems for scoring vital functions. The author discusses the ethical aspects of withholding and withdrawing treatment and resuscitation in the ICU. He maintains that the pediatric ICU must not be a place reserved for the dying and terminal patients. He stresses the role of the patient's relatives, and their need for due information and counselling. The importance of continuing education of the ICU staff is emphasized.