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Updated: Feb 7, 2026
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Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure
Published on: September 19, 2019
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When a Child Dies in the PICU Despite Ongoing Life Support
Mithya Lewis-Newby1,2, Jonna D Clark1,2, Warwick W Butt3,4
1Divisions of Pediatric Critical Care Medicine and Pediatric Bioethics, Department of Pediatrics, University of Washington, Seattle, WA.
Summary
Understanding end-of-life care in pediatric intensive care units (PICUs) is crucial when treatment goals shift from cure to comfort. This involves navigating complex family and clinician perspectives to ensure optimal support for dying children.
Area of Science:
- Pediatric critical care medicine
- End-of-life care research
- Bioethics in pediatrics
Background:
- Deaths in pediatric intensive care units (PICUs) often occur despite ongoing curative or life-prolonging treatment goals.
- Navigating these complex situations presents unique challenges for clinicians, families, and healthcare systems.
Purpose of the Study:
- To examine the circumstances surrounding death in the PICU when curative or life-prolonging goals are maintained.
- To explore challenges in providing high-quality end-of-life care in this context.
- To offer suggestions for improving end-of-life care for children in PICUs.
Main Methods:
- Multidisciplinary expert group review.
- Analysis of current medical literature.
- Description of common clinical scenarios and stakeholder perspectives.
Main Results:
- Three common clinical scenarios are presented where death is likely despite continued curative efforts.
- Challenges in delivering optimal end-of-life care are identified.
- Perspectives of families and PICU clinicians are explored to understand complex deaths.
Conclusions:
- Merging curative interventions with optimal end-of-life care is achievable through flexibility and open-mindedness.
- Addressing barriers and aligning perspectives can reduce conflict.
- Prioritizing the dying child and family remains central to care.
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