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Towards developing an ethical framework for decision making in long-term ventilation in children

Samiran Ray1,2,3, Joe Brierley1,3,4, Andy Bush5,6

  • 1Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children, London, UK.

Archives of Disease in Childhood
|June 7, 2018
PubMed

Insights

Long-term ventilation (LTV) for children is increasing globally due to technological advances and wider acceptance. This article presents an ethical framework for LTV decision-making, balancing potential benefits against prolonged suffering.

Area of Science:

  • Pediatric critical care medicine
  • Respiratory medicine
  • Medical ethics

Background:

  • Long-term ventilation (LTV) use in children is rising globally.
  • Improved technology, expanded indications, and increased family acceptance drive this trend.

Purpose of the Study:

  • To discuss considerations for initiating or continuing LTV in pediatric patients.
  • To outline a consensus-based process for LTV decision-making.
  • To present an ethical framework for LTV decisions, addressing novel therapies.

Main Methods:

  • Consensus development among experienced pediatric physicians.
  • Review of ethical considerations regarding LTV and emerging treatments.
  • Discussion of conflict resolution strategies in LTV decision-making.

Main Results:

  • A structured approach to LTV decision-making is proposed.
  • The framework addresses the ethical dilemma of using LTV to trial uncertain therapies.
  • Options for resolving conflicts in LTV decisions are outlined.

Conclusions:

  • An ethical framework is provided to guide decisions on pediatric long-term ventilation.
  • The framework aims to balance the potential benefits of LTV with the risk of prolonged suffering.
  • It supports informed decision-making for children requiring LTV, considering novel therapeutic options.

Keywords:
ethicshealth servicerespiratory

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