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Honoring do-not-attempt-resuscitation requests in schools.
Pediatrics
|April 28, 2010
Summary
Children with complex conditions may refuse life-sustaining treatment at school. Pediatricians can help create action plans for comfort care, ensuring student preferences are honored.
Area of Science:
- Pediatric Healthcare
- Bioethics
- School Health Services
Background:
- Increasing numbers of children and adolescents with complex chronic conditions reside in community settings.
- Federal laws support school participation for these students.
- Families may opt to forgo life-sustaining treatments like cardiopulmonary resuscitation (CPR) due to ineffectiveness or risk-benefit analysis.
Purpose of the Study:
- To explore the complexities of honoring patient and family preferences regarding life-sustaining treatment in the school environment.
- To identify the role of pediatricians in supporting these decisions within schools.
- To advocate for policies and legislation that facilitate patient autonomy in school settings.
Main Methods:
- Review of current legislation and regulations concerning medical treatment in schools.
- Analysis of challenges faced by school nurses and healthcare providers.
- Discussion of the pediatrician's role in developing individualized health care plans (IHPs).
Main Results:
- Honoring treatment refusal requests in schools is challenging due to limited school nurse availability and inconsistent state laws.
- Collaboration between families, schools, and healthcare providers is crucial.
- Pediatricians can facilitate the creation of communication and comfort-care plans within IHPs.
Conclusions:
- Pediatricians play a vital role in developing specific action plans for students with complex conditions, including comfort-care directives.
- Advocacy for supportive legislation and policies is essential to enable students and families to exercise their preferences regarding medical treatment in schools.
- Enhanced collaboration and understanding among all stakeholders are necessary to navigate these complex ethical and practical issues.
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