Journal of law and medicine
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Withholding and withdrawing life-sustaining medical treatment are common in paediatric practice, especially in intensive care units. However, not all clinicians apparently adhere to principles in ethical guidelines or to the principles which are to be found in judgments from common law cases arising when doctors and parents dispute treatment. This article examines selected ethical guidelines and compares them to judgments in leading cases. ⋯ Although "best interests" must essentially pertain to the individual child, the interests of others are not irrelevant. In legal cases "best interests" of the child are defined in terms such as "burden versus benefit", "futility", "indignity", "intolerability", "prolonging death rather than saving life" and "quality of life". These or like terms should form the basis of ethical decisions in discussions with parents when contemplating withholding or withdrawing life-sustaining treatment.
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This article critically examines the successes and failures of the current internal and external regulatory regimes for ensuring the delivery of patient safety in public hospitals. It argues that governments should develop a holistic approach to regulation through the enhancement of existing compliance mechanisms in conjunction with some formal regulation to ensure that public hospital systems-deliver high standards of service with minimal patient harm. It recommends that a Patient Safety Authority be established in order to assist with the monitoring of incidents and the enforcement of compliance with patient safety standards.