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Shared decisions in pediatric critical care

Francisco José Cambra Lasaosa1, Irene Amores Hernández2, Belén Calderón Llopis2

  • 1Pediatric Intensive Care Unit, Sant Joan de Deu Hospital, Barcelona, Spain.

Medicina Intensiva
|July 27, 2026
PubMed

Insights

Shared decision-making in pediatric critical care requires careful communication and ethical consideration for children with complex conditions. Developing consensus-based care plans ensures the child

Area of Science:

  • Pediatric Critical Care Medicine
  • Bioethics
  • Healthcare Communication

Background:

  • Shared decision-making in pediatric critical care presents significant challenges, particularly for children with chronic complex conditions and during end-of-life care.
  • Ethical conflicts can arise during the decision-making process, necessitating awareness and specific skills among healthcare professionals.

Purpose of the Study:

  • To outline the complexities and ethical considerations in shared decision-making for pediatric critical care.
  • To emphasize the importance of communication skills and a holistic approach in developing pediatric care plans.
  • To advocate for consensus-based anticipated care plans that prioritize the child's best interests.

Main Methods:

  • Discussion of ethical principles and communication strategies relevant to pediatric critical care decision-making.
  • Analysis of factors influencing care planning, including technical aspects, prognosis, and psychosocial elements.
  • Emphasis on collaborative approaches involving families and healthcare professionals.

Main Results:

  • Effective decision-making requires balancing medical information with the child's and family's unique needs (physical, psychoemotional, social, spiritual).
  • Prognostic uncertainty must be addressed within the care planning process.
  • Consensus-based plans are crucial for guiding professional actions and ensuring clarity.

Conclusions:

  • Healthcare professionals need specialized training in communication and ethics for pediatric critical care shared decision-making.
  • Care plans must be comprehensive, considering all aspects of the child and family's well-being.
  • Establishing consensus-based anticipated care plans is vital for ethical and effective pediatric critical care.

Keywords:
Anticipated care plansCalidad de vidaClima éticoClinical ethicsCommunicationComunicaciónDecision makingEthical climateMature minorMenor maduroPediatricsPediatríaPlanificación anticipada de la atenciónProporcionalidad terapéuticaQuality of lifeTherapeutic proportionalityToma de decisionesÉtica asistencial

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