Archives of disease in childhood
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To investigate attitudes towards physician-assisted death in minors among all physicians involved in the treatment of children dying in Flanders, Belgium over an 18-month period, and how these are related to actual medical end-of-life practices. ⋯ A majority of surveyed Flemish physicians appear to accept physician-assisted dying in children under certain circumstances and favour an amendment to the euthanasia law to include minors. The approach favoured is one of assessing decision-making capacity rather than setting arbitrary age limits. These stances, and their connection with actual end-of-life practices, may encourage policy-makers to develop guidelines for medical end-of-life practices in minors that address specific challenges arising in this patient group.
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When children are considered for participation in research, British and international guidelines suggest that they should provide assent in addition to their parents' consent. However, examination of these guidelines shows there is confusion regarding the concept of assent. Furthermore, the need for assent may cause problems. The guidelines should be revised: the parents of incompetent children should consent for them and competent children should consent on their own behalf.
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In the UK, the number of patients waiting for an organ transplant has increased by 30% since 2001. Non-heart beating organ donation (NHBD) programmes are advocated as a means of increasing the number of potential donors. Such programmes remain in their infancy within paediatrics. We examined all deaths in our paediatric intensive care unit (PICU) between January 2005 and December 2008 to establish the number of potential NHB donors. We further obtained data from UK NHS Blood and Transplant detailing all paediatric patients that became heart beating and NHB donors in the UK over the same period. ⋯ If this situation were replicated in the PICUs throughout the UK, it would represent a significant increase in the number of organs available for transplantation.
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In previous studies, lenticulostriated vasculopathy (LSV) was detected in 0.4-5.8% of neonates who had undergone brain ultrasound studies during the neonatal period. Most infants were referred from neonatal intensive care units. Various clinical conditions were associated with LSV including intrauterine infections. ⋯ LSV is a common finding in infants with symptomatic congenital CMV infection and is a sign of CNS involvement. Moreover, LSV is a possible marker of high risk for sensorineural hearing loss in infants with congenital CMV infection.