Working with children in end-of-life decision making

Area of Science:

• Pediatric Ethics
• Bioethics
• Nursing Ethics

Background:

• Historically, healthcare decisions for children were physician- and parent-led.
• Evolving legal and ethical frameworks now recognize children's participation in decision-making.
• Challenges persist regarding children's cognitive development and understanding in healthcare contexts.

Purpose of the Study:

• To explore the ethical complexities nurses face in pediatric end-of-life care.
• To examine the challenges of involving children with varying cognitive abilities in healthcare decisions.
• To analyze conflicts arising from multiple surrogate decision-makers and differing views on children's best interests.

Main Methods:

• Utilized case studies with anonymized details.
• Focused on end-of-life care scenarios involving children and families.
• Examined ethical challenges from a nursing perspective.

Main Results:

• Children's increasing participation in healthcare decisions presents ethical dilemmas.
• Assessing children's capacity for understanding is complex across developmental levels.
• Conflicts among parents and professionals regarding children's best interests are common.

Conclusions:

• Empowering children with a voice and choices enhances their dignity and quality of life.
• Nurses navigate significant ethical challenges in pediatric end-of-life care.
• Addressing these complexities requires careful consideration of child development and shared decision-making.