Drafting guidelines for the withholding or withdrawing of life sustaining treatment in critically ill children and neonates.
نویسندگان
چکیده
In 1997, the Royal College of Paediatrics and Child Health (RCPCH) published a framework for practice on the withholding or withdrawing of life sustaining treatment. Based on sound ethical and legal principles, the purpose of the document was to oVer guidance for those faced with diYcult treatment decisions that could not be resolved by appeal to scientific fact alone. Unsurprisingly, the RCPCH document has attracted both acclaim and some criticism for its general objectives and specific conclusions. 3 Any attempt to provide such guidance might be interpreted as applying unnecessary constraints to clinical practice. Furthermore, such documents can be criticised as being too general to be useful, stigmatising to some individuals or groups, and striking the wrong balance between law and morality. Although these criticisms have some validity, questions such as those dealt with by the RCPCH document and others cannot simply be left to the moral values of individual clinicians or their (possibly mistaken) interpretation of the law. Some considered advice—informed by appropriate collective multidisciplinary deliberation—is imperative. It seems likely, therefore, that other groups will wish to provide guidance or advice on ethicolegal matters. Here, we examine some of the problems they may face by considering the kind of guidance that is required, the appropriateness of standards set, the role of the law, and the relation between guidelines and the law.
منابع مشابه
Physicians' decisions to withhold and withdraw life-sustaining treatment.
BACKGROUND Few data are available about physicians' decisions in regard to withholding or withdrawing life-sustaining measures. We therefore studied internists' views on this subject. METHODS We surveyed 1000 generalist and subspecialist internists about their views on withholding or withdrawing life-sustaining treatment. Thirty-two hypothetical cases were included. The effect of the demograp...
متن کاملWithholding and withdrawing life-sustaining treatment in children.
Modern medicine gives us the ability to prolong life even in situations where it may not be right to do so. This article discusses some of the complex ethical and legal issues surrounding withholding and withdrawing life-sustaining treatment in children, including the concepts of futility, best interests and intolerability. We advocate the use of a structured framework to help guide decision-ma...
متن کاملنگرش و عملکرد پزشکان اطفال و زنان و زایمان شهرستانهای ساری و بابل در مورد قطع اقدامات احیا در نوزادان بسیار بدحال
Background and purpose: There are some debates with decision making for withdrawal/ withholding of life sustaining treatment in infants with adverse prognoses and incurable conditions. This study is conducted to review attitudes and practice of pediatrics and gynecology physicians in this field. Materials and methods: This survey was conducted during 2009 in Sari and Babol. A total of 140 pe...
متن کاملParental views on withdrawing life-sustaining therapies in critically ill children.
OBJECTIVE To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. DESIGN Quantitative and qualitative analysis of semi-structured one-on-one interviews. SETTING The PICUs at 2 tertiary care h...
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ورودعنوان ژورنال:
- Archives of disease in childhood. Fetal and neonatal edition
دوره 83 1 شماره
صفحات -
تاریخ انتشار 2000