Very sick children: treatment at any cost? New framework to help doctors make tough decisions on end
Last updated: Wednesday 25 March 2015 at 2am PST 6
Pediatrics / Children’s Health Palliative Care / Hospice Care Primary Care / General Practice add your opinionemailAdapted media release
Doctors dealing with end of life care for children and young people will be issued with a new framework for practice, setting out when it can be considered no longer in the best interests of the child to give life sustaining treatment (LST).
Making decisions to limit treatment in life-limiting and life-threatening conditions in children, published by the Royal College of Paediatrics and Child Health (RCPCH) provides an ethical and legal framework for doctors and has been written by medics, lawyers and ethicists.
The framework provides three sets of circumstances when limiting treatment can be considered because it is no longer in the child’s best interests to continue:
When life is limited in quantity – If treatment is unable or unlikely to prolong life significantly it may not be in the child’s best interests to provide it
When life is limited in quality: This includes situations where treatment may be able to prolong life significantly but will not alleviate the burdens associated with illness or treatment itself
Informed competent refusal of treatment An older child with extensive experience of illness may repeatedly and competently consent to the withdrawal or withholding of LST. In these circumstances, and where the child is supported by his or her parents and by the clinical team, there is no ethical obligation to provide LST.