Journal of pediatric intensive care
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J Pediatr Intensive Care · Sep 2014
ReviewEthical challenges with the advancement of hematopoietic stem cell transplant.
Advancements in medical science and pediatric intensive care have significantly improved outcomes for children undergoing hematopoietic stem cell transplantation (HSCT). Critical care management of HSCT patients requires pediatric intensivists to deal with ethical issues including aggressiveness of care and futility, limiting treatment, shared decision-making with families of critically ill children, and decision-making in the context of multi-disciplinary management of complex patients. This paper will discuss the fundamental ethical principles to enable pediatric intensivists to address questions of medical decision-making. ⋯ A framework for end of life communication with families will be provided. Finally, this paper will discuss the potential conflicts resulting from multi-disciplinary care of the HSCT patient in the pediatric intensive care unit. As medical management of the HSCT patient continues to evolve, awareness of the ethical issues surrounding their care is important for both patient and provider.