Guidance on forgoing life-sustaining medical treatment

COMMITTEE ON BIOETHICS, SECTION ON HOSPICE AND PALLIATIVE MEDICINE, COMMITTEE ON CHILD ABUSE AND NEGLECT

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Pediatric health care is practiced with the goal of promoting the best interests of the child. Treatment generally is rendered under a presumption in favor of sustaining life. However, in some circumstances, the balance of benefits and burdens to the child leads to an assessment that forgoing life-sustaining medical treatment (LSMT) is ethically supportable or advisable. Parents are given wide latitude in decision-making concerning end-of-life care for their children in most situations. Collaborative decision-making around LSMT is improved by thorough communication among all stakeholders, including medical staff, the family, and the patient, when possible, throughout the evolving course of the patient's illness. Clear communication of overall goals of care is advised to promote agreed-on plans, including resuscitation status. Perceived disagreement among the team of professionals may be stressful to families. At the same time, understanding the range of professional opinions behind treatment recommendations is critical to informing family decision-making. Input from specialists in palliative care, ethics, pastoral care, and other disciplines enhances support for families and medical staff when decisions to forgo LSMT are being considered. Understanding specific applicability of institutional, regional, state, and national regulations related to forgoing LSMT is important to practice ethically within existing legal frameworks. This guidance represents an update of the 1994 statement from the American Academy of Pediatrics on forgoing LSMT.

Original languageEnglish (US)
Article numbere20171905
JournalPediatrics
Volume140
Issue number3
DOIs
StatePublished - Sep 1 2017

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Decision Making
Medical Staff
Therapeutics
Communication
Pastoral Care
Patient Care Planning
Pediatrics
Terminal Care
Palliative Care
Resuscitation
Ethics
Parents
Delivery of Health Care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

COMMITTEE ON BIOETHICS, SECTION ON HOSPICE AND PALLIATIVE MEDICINE, COMMITTEE ON CHILD ABUSE AND NEGLECT (2017). Guidance on forgoing life-sustaining medical treatment. Pediatrics, 140(3), [e20171905]. https://doi.org/10.1542/peds.2017-1905

Guidance on forgoing life-sustaining medical treatment. / COMMITTEE ON BIOETHICS, SECTION ON HOSPICE AND PALLIATIVE MEDICINE, COMMITTEE ON CHILD ABUSE AND NEGLECT.

In: Pediatrics, Vol. 140, No. 3, e20171905, 01.09.2017.

Research output: Contribution to journalArticle

COMMITTEE ON BIOETHICS, SECTION ON HOSPICE AND PALLIATIVE MEDICINE, COMMITTEE ON CHILD ABUSE AND NEGLECT 2017, 'Guidance on forgoing life-sustaining medical treatment', Pediatrics, vol. 140, no. 3, e20171905. https://doi.org/10.1542/peds.2017-1905
COMMITTEE ON BIOETHICS, SECTION ON HOSPICE AND PALLIATIVE MEDICINE, COMMITTEE ON CHILD ABUSE AND NEGLECT. Guidance on forgoing life-sustaining medical treatment. Pediatrics. 2017 Sep 1;140(3). e20171905. https://doi.org/10.1542/peds.2017-1905
COMMITTEE ON BIOETHICS, SECTION ON HOSPICE AND PALLIATIVE MEDICINE, COMMITTEE ON CHILD ABUSE AND NEGLECT. / Guidance on forgoing life-sustaining medical treatment. In: Pediatrics. 2017 ; Vol. 140, No. 3.
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abstract = "Pediatric health care is practiced with the goal of promoting the best interests of the child. Treatment generally is rendered under a presumption in favor of sustaining life. However, in some circumstances, the balance of benefits and burdens to the child leads to an assessment that forgoing life-sustaining medical treatment (LSMT) is ethically supportable or advisable. Parents are given wide latitude in decision-making concerning end-of-life care for their children in most situations. Collaborative decision-making around LSMT is improved by thorough communication among all stakeholders, including medical staff, the family, and the patient, when possible, throughout the evolving course of the patient's illness. Clear communication of overall goals of care is advised to promote agreed-on plans, including resuscitation status. Perceived disagreement among the team of professionals may be stressful to families. At the same time, understanding the range of professional opinions behind treatment recommendations is critical to informing family decision-making. Input from specialists in palliative care, ethics, pastoral care, and other disciplines enhances support for families and medical staff when decisions to forgo LSMT are being considered. Understanding specific applicability of institutional, regional, state, and national regulations related to forgoing LSMT is important to practice ethically within existing legal frameworks. This guidance represents an update of the 1994 statement from the American Academy of Pediatrics on forgoing LSMT.",
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