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Withholding aggressive seizure treatment from a child with severe intractable epilepsy: a case study

Jennifer R Boyd1, Mara Hebbard

  • 1Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada. jennifer.boyd@sickkids.ca

The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses
|April 30, 2004
PubMed

Insights

Withholding aggressive treatment for severe epilepsy in a child with profound neurological impairment shifted care to palliative measures. This case study explores the ethical considerations and nursing interventions during this transition.

Area of Science:

  • Pediatric Neurology
  • Palliative Care Medicine
  • Clinical Ethics

Background:

  • Severe intractable epilepsy presents significant challenges to quality of life in children.
  • Aggressive seizure treatments raise ethical questions regarding benefit versus burden.
  • Prolonged hospitalizations for status epilepticus impact the child and family.

Observation:

  • A case study detailing the decision-making process to transition from aggressive seizure management to palliative care for a child with severe neurological impairment.
  • Exploration of the ethical dilemmas encountered by the healthcare team.
  • Review of nursing issues and interventions implemented during the palliative care transition.

Findings:

  • The transition to palliative care involved complex ethical considerations and required tailored nursing interventions.
  • The case highlights the challenges in managing intractable epilepsy and its impact on quality of life.
  • Lessons learned emphasize the importance of interdisciplinary collaboration in end-of-life care decisions for children.

Implications:

  • This case informs clinical practice regarding the management of severe, intractable pediatric epilepsy.
  • It underscores the critical role of palliative care in improving quality of life for children with profound neurological impairment.
  • The study contributes to the ethical discourse on aggressive treatment withdrawal in pediatric neurology.

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