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                <text>A Good Resource For Parents, But Will Clinicians Use It?: Evaluation Of A Resource For Paediatric End-of-life Decision Making</text>
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                <text>Bmc Palliative Care</text>
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                <text>Delany C; Xafis V; Gillam L; Hughson JA; Hynson J; Wilkinson D</text>
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                <text>BACKGROUND: Communication with parents about end-of-life care and decisions is a difficult and sensitive process. The objective of the present study was to ascertain clinicians' views on the acceptability and usefulness of a handbook and web-based resource (Caring Decisions) that was designed as an aid for parents facing end-of-life decisions for their child. METHODS: Qualitative interviews were conducted with a range of health professionals who provide care to children facing life-limiting conditions. RESULTS: Data analysis confirmed the acceptability and usefulness of the resource. Two major themes were revealed: 1. Family empowerment, with sub-themes Giving words and clarity, Conversation starter, 'I'm not alone in this', and A resource to take away, highlighted how the resource filled a gap by supporting and enabling families in a multitude of ways; 2. Not just for families, with sub-themes A guide for staff, When to give the resource?, How to give the resource and Who should give the resource?, explored the significant finding that participants viewed the resource as a valuable tool for themselves, but its presence also brought into relief potential gaps in communication processes around end-of-life care. CONCLUSION: The interview data indicated the positive reception and clear value and need for this type of resource. However, it is likely that successful resource uptake will be contingent on discussion and planning around dissemination and use within the health care team.</text>
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                <text>Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).</text>
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        <name>Delany C</name>
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        <name>Gillam L</name>
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        <name>Hughson JA</name>
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                  <text>May 2022 List</text>
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              <text>May 2022 List</text>
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              <text>&lt;a href="http://doi.org/10.1136/archdischild-2021-323500" target="_blank" rel="noreferrer noopener"&gt;http://doi.org/​10.1136/archdischild-2021-323500&lt;/a&gt;</text>
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                <text>Crossing the line? Ethics of parenteral nutrition in paediatric neurodisability complicated by intestinal failure</text>
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                <text>Archives of Disease in Childhood</text>
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                <text>Ethics; Intestinal failure; Neurodisability; Parenteral nutrition; Pediatrics</text>
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                <text>McCallum Z; Delany C; Gillam L</text>
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                <text>Children with severe neurological impairment (such as cerebral palsy or congenital anomalies) are living longer, although medically complex, lives. Feeding intolerance is an increasing problem that is emerging as a new end-of-life issue. Long-term parenteral nutrition (LTPN) is technically feasible in these children. However, clinicians are concerned about whether it is appropriate in these circumstances or whether it constitutes a treatment 'too far'. This narrative review of the literature identifies, categorises and explores the ethical foundations and reasons for clinician hesitancy about the use of LTPN in this population. The categories of reasons are: lack of clear diagnostic criteria for feeding failure; risks of LTPN to the child; burden of LTPN to the family/caregivers; burden of LTPN to the child; difficulty in cessation of LTPN; and the concept that feeding failure may be a preterminal sign. These reasons are all ultimately about risks and burden outweighing the benefits. We argue that the risks of LTPN have decreased over time, the burden for individual children and their parents may be less than imagined, and the benefit is a realistic prospect. Case-by-case consideration, giving due weight to child and parental perspectives, can show that LTPN is ethically justified for some children with severe neurological impairment. Copyright © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</text>
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                <text>&lt;a href="http://doi.org/10.1136/archdischild-2021-323500" target="_blank" rel="noreferrer noopener"&gt;10.1136/archdischild-2021-323500&lt;/a&gt;</text>
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