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Best Pract Res Clin Anaesthesiol · Dec 2006
Limiting and rationing treatment in paediatric and neonatal intensive care.
- Peter-Marc Fortune.
- Royal Manchester Children's Hospital, Pendlebury, Manchester M20 3FJ, UK. peter-marc.fortune@manchester.ac.uk
- Best Pract Res Clin Anaesthesiol. 2006 Dec 1; 20 (4): 577-88.
AbstractIn this chapter I consider the ethical decisions surrounding the provision and limitation of treatment offered to children requiring intensive care. I focus on the processes surrounding end of life decision making and consider how the concepts of futility, burden and uncertainty should impact upon these decisions. I also examine resource allocation to children's critical care services. The discussion does not provide a structure that will solve any given situation. It does take a practical approach to the issues faced by considering why we should engage in life limiting discussions; When they should occur; Who should be involved; How they should be carried out; and where and by what means withholding or withdrawal should occur. I have drawn the discussions closer to clinical practice with the intention of making them more useful, for those engaged in direct patient care, than those focused around philosophical principles.
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