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Guidance on Forgoing Life-Sustaining Medical Treatment.

Kathryn L Weise, Alexander L Okun, Brian S Carter

    Pediatrics
    |August 30, 2017
    PubMed
    Summary
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    Forgoing life-sustaining medical treatment (LSMT) in pediatric care may be ethically advisable when benefits do not outweigh burdens. Open communication among medical teams, families, and patients is crucial for informed end-of-life decisions.

    Area of Science:

    • Pediatric Healthcare Ethics
    • Bioethics
    • Medical Decision-Making

    Background:

    • Pediatric healthcare prioritizes the child's best interests, generally favoring life-sustaining treatment.
    • Ethical considerations arise when the burdens of life-sustaining medical treatment (LSMT) outweigh potential benefits for a child.
    • Parental autonomy is significant in end-of-life care decisions for children.

    Purpose of the Study:

    • To provide updated guidance on ethically forgoing life-sustaining medical treatment (LSMT) in pediatric care.
    • To emphasize the importance of collaborative decision-making in end-of-life pediatric care.
    • To address the complexities of balancing treatment benefits and burdens in pediatric end-of-life scenarios.

    Main Methods:

    • Review of ethical principles and clinical best practices in pediatric end-of-life care.

    Related Experiment Videos

  • Analysis of the role of communication among healthcare professionals, families, and patients.
  • Consideration of legal and regulatory frameworks impacting decisions to forgo LSMT.

    • Main Results:

    • Collaborative decision-making is enhanced by clear, consistent communication regarding goals of care and resuscitation status.
    • Understanding diverse professional opinions and seeking interdisciplinary input (palliative care, ethics, etc.) supports families and staff.
    • Adherence to institutional, regional, state, and national regulations is essential for ethical practice.

    Conclusions:

    • Forgoing LSMT can be ethically supportable when deemed to be in the child's best interest.
    • Effective communication and shared decision-making are paramount throughout the illness trajectory.
    • Updated guidance is necessary to navigate complex ethical and legal considerations in pediatric end-of-life care.