1
40
16
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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URL Address
<a href="http://doi.org/10.1542/peds.2013-3608F" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2013-3608F</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Judging the quality of mercy: drawing a line between palliation and euthanasia
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
Subject
The topic of the resource
Child; Humans; Pediatrics; Euthanasia; Ethics; Suicide; Medical; Palliative Care; Assisted; Passive; 20th Century; History
Creator
An entity primarily responsible for making the resource
Morrison WE; Kang TI
Description
An account of the resource
Clinicians frequently worry that medications used to treat pain and suffering at the end of life might also hasten death. Intentionally hastening death, or euthanasia, is neither legal nor ethically appropriate in children. In this article, we explore some of the historical and legal background regarding appropriate end-of-life care and outline what distinguishes it from euthanasia. Good principles include clarity of goals and assessments, titration of medications to effect, and open communication. When used appropriately, medications to treat symptoms should rarely hasten death significantly. Medications and interventions that are not justifiable are also discussed, as are the implications of palliative sedation and withholding fluids or nutrition. It is imperative that clinicians know how to justify and use such medications to adequately treat suffering at the end of life within a relevant clinical and legal framework.
2014-02
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2013-3608F" target="_blank" rel="noreferrer">10.1542/peds.2013-3608F</a>
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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).
Type
The nature or genre of the resource
Journal Article
2014
20th Century
Assisted
Backlog
Child
Ethics
Euthanasia
History
Humans
Journal Article
Kang TI
Medical
Morrison WE
Palliative Care
Passive
Pediatrics
Suicide
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2009-0621" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2009-0621</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Attitudes of adolescent cancer survivors toward end-of-life decisions for minors.
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Subject
The topic of the resource
Child; Female; Humans; Male; Euthanasia; Netherlands; Truth Disclosure; Sick Role; Right to Die; adolescent; Psychological; DNAR; Attitude to Death; Suicide; Assisted/px [Psychology]; Interview; decision making; Advance Directives; Passive; Palliative Care/px [Psychology]; Terminal Care/px [Psychology]; Neoplasms/px [Psychology]; Minors/px [Psychology]; Survivors/px [Psychology]; Euthanasia/px [Psychology]; Informed Consent/px [Psychology]
Creator
An entity primarily responsible for making the resource
Pousset G; Bilsen J; De Wilde J; Benoit Y; Verlooy J; Bomans A; Deliens L; Mortier F
Description
An account of the resource
OBJECTIVES: The present study aimed to investigate the attitudes of adolescent cancer survivors toward end-of-life decisions with life-shortening effects, including nontreatment decisions (NTDs), intensified alleviation of pain and symptoms (APS), and euthanasia, and the influence of illness experience on these attitudes., METHODS: Adolescent cancer survivors were interviewed with a structured questionnaire using hypothetical case descriptions. The results were compared with a study of 1769 adolescents without experience of chronic illness., RESULTS: Eighty-three adolescents, 11 to 18 years of age, were interviewed. In terminal situations, 70% to 90% found requests for NTDs acceptable, 84% requests for APS, and 57% to 64% requests for euthanasia. Requests for end-of-life decisions were less acceptable in nonterminal situations, where 28% found requests for NTDs acceptable, 39% to 47% requests for APS, and 11% to 21% requests for euthanasia. Frequently cited reasons for holding back physicians from administering a lethal drug to a child were the child not being well informed about his or her condition (92%) and the parents' opinion not being asked (92%). Compared with adolescents without experience with chronic illness, cancer survivors were more accepting toward requests for NTDs and APS in terminal situations., CONCLUSIONS: Adolescent cancer survivors, like other adolescents, want to be involved in medical decision-making at the end of life. They value autonomous decision-making, without excluding parents from the process. The experience of living through a life-threatening illness can alter adolescents' attitudes toward requests for NTDs and APS.
2009
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2009-0621" target="_blank" rel="noreferrer">10.1542/peds.2009-0621</a>
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Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2009
Adolescent
Advance Directives
Assisted/px [Psychology]
Attitude To Death
Backlog
Benoit Y
Bilsen J
Bomans A
Child
De Wilde J
Decision Making
Deliens L
DNAR
Euthanasia
Euthanasia/px [Psychology]
Female
Humans
Informed Consent/px [Psychology]
Interview
Journal Article
Male
Minors/px [Psychology]
Mortier F
Neoplasms/px [psychology]
Netherlands
Palliative Care/px [psychology]
Passive
Pediatrics
Pousset G
Psychological
Right to Die
Sick Role
Suicide
Survivors/px [psychology]
Terminal Care/px [psychology]
Truth Disclosure
Verlooy J
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/01.ccm.0000084805.15352.01" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.ccm.0000084805.15352.01</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Attitudes and preferences of intensivists regarding the role of family interests in medical decision making for incompetent patients
Publisher
An entity responsible for making the resource available
Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Child; Cross-Sectional Studies; Female; Humans; infant; Male; United States; Mental Competency; Adult; Data Collection; Attitude of Health Personnel; Middle Aged; Professional-Family Relations; Euthanasia; Religion and Medicine; Legal Guardians; Morals; Intensive Care; Hospitals; Ethics; Teaching; Medical; decision making; Newborn; ICU Decision Making; Passive
Creator
An entity primarily responsible for making the resource
Hardart GE; Truog RD
Description
An account of the resource
OBJECTIVE: The role of family interests in medical decision making is controversial. Physicians who routinely treat incompetent patients may have preferred strategies for addressing family interests as they are encountered in surrogate medical decision making. We sought to determine how physicians view the role of family interests in surrogate medical decision making. DESIGN: Cross-sectional mail survey. SETTING: Remote study.PATIENTS: Surveyed were neonatologists, pediatric intensivists, and medical intensivists affiliated with American medical schools. MEASUREMENTS AND MAIN RESULTS: A total of 327 (55%) of 596 surveys were returned; 35% of respondents were pediatric intensivists, 39% were neonatologists, and 26% were medical intensivists. The majority of respondents believed that family interests should be considered in decisions for incompetent patients, even if those interests are not necessarily important interests of the patient. Less than 10% preferred the traditional model in which the physician-patient relationship is exclusive and family interests are excluded. Medical intensivists, and those who described themselves as more religious, more opposed to healthcare rationing, and more protective of patients, tended to prefer patient-centered surrogate decision-making models. Physicians who treat children, especially neonatologists, were more accepting of family-centered surrogate decision-making models than were physicians who exclusively treat adults. CONCLUSIONS: A majority of the academic intensivists in our study believed that family interests should play an important role in medical decision making for incompetent patients. Our findings suggest that the traditional view of the physician-patient relationship may represent an overly simplistic model for medical decision making.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.ccm.0000084805.15352.01" target="_blank" rel="noreferrer">10.1097/01.ccm.0000084805.15352.01</a>
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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).
Type
The nature or genre of the resource
Journal Article
2003
Adult
Attitude Of Health Personnel
Backlog
Child
Critical Care Medicine
Cross-sectional Studies
Data Collection
Decision Making
Ethics
Euthanasia
Female
Hardart GE
Hospitals
Humans
ICU Decision Making
Infant
Intensive Care
Journal Article
Legal Guardians
Male
Medical
Mental Competency
Middle Aged
Morals
Newborn
Passive
Professional-family Relations
Religion and Medicine
Teaching
Truog RD
United States
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/01.pcc.0000123547.28099.44" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.pcc.0000123547.28099.44</a>
Dublin Core
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Title
A name given to the resource
A descriptive study of children dying in the pediatric intensive care unit after withdrawal of life-sustaining treatment
Publisher
An entity responsible for making the resource available
Pediatric Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Child; Female; Humans; Male; Intensive Care Units; Palliative Care; Euthanasia; Patient Participation; Time Factors; Pediatric; adolescent; Preschool; infant; retrospective studies; ICU Decision Making; Parents/psychology; Analgesics/administration & dosage; Hypnotics and Sedatives/administration & dosage; Passive; Neuromuscular Blockade
Creator
An entity primarily responsible for making the resource
Zawistowski CA; DeVita MA
Description
An account of the resource
OBJECTIVE: To examine physiologic and therapeutic changes following withdrawal of life-sustaining treatment in children. DESIGN: Retrospective chart review. SETTING: University-affiliated tertiary care pediatric hospital. PATIENTS: All patients who had life-sustaining treatment withdrawn over a 5-yr period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 125 charts were examined to obtain 50 in which the terminal event preceding death was withdrawal of life-sustaining treatment. Data are expressed as median (1st, 3rd quartiles). Median hospital stay before death was 20 days (1st and 3rd quartiles, 8 and 30). Median time from decision to withdraw life-sustaining treatment to actual withdrawal was 30 mins (1st and 3rd quartiles, 10 and 180). All interventions were simultaneously discontinued in 80% of patients with mechanical ventilation followed by vasopressors being most common. No patients had stepwise reduction in ventilator rate before discontinuing the mechanical ventilation. Devices were rarely removed from patients including endotracheal tubes. Time from withdrawal of life-sustaining treatment to death was 15 mins (5, 30); only seven patients took >60 mins to die. Multivariable analysis (Kruskal-Wallis test) of various factors revealed simultaneous withdrawal of life-sustaining treatment, female gender, and not having received renal therapy as hastening death. CONCLUSIONS: Forgoing life-sustaining treatment in a small cohort of children at a single institution follows a pattern: Most cases occur after prolonged intensive care unit stays, withdrawal of treatment occurs almost immediately after the decision to withdraw, most treatments are withdrawn simultaneously rather than sequentially, and most patients die within minutes of life-sustaining treatment cessation. This is the first pediatric study to report the time to death after withdrawal of life-sustaining treatment and factors associated with shorter time to death in children.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.pcc.0000123547.28099.44" target="_blank" rel="noreferrer">10.1097/01.pcc.0000123547.28099.44</a>
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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).
Type
The nature or genre of the resource
Journal Article
2004
Adolescent
Analgesics/administration & dosage
Backlog
Child
DeVita MA
Euthanasia
Female
Humans
Hypnotics and Sedatives/administration & dosage
ICU Decision Making
Infant
Intensive Care Units
Journal Article
Male
Neuromuscular Blockade
Palliative Care
Parents/psychology
Passive
Patient Participation
Pediatric
Pediatric Critical Care Medicine
Preschool
Retrospective Studies
Time Factors
Zawistowski CA
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/s0022-3476(88)80262-2" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0022-3476(88)80262-2</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Withholding nutrition from seriously ill newborn infants: a parent's perspective
Publisher
An entity responsible for making the resource available
The Journal Of Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
1988
Subject
The topic of the resource
Humans; infant; Male; Adult; Parents; Withholding Treatment; Euthanasia; Age Factors; Patient Selection; Morals; Enteral Nutrition; Death and Euthanasia; Newborn; Euthanasia; Brain Diseases; Diseases; Jurisprudence; Passive
Creator
An entity primarily responsible for making the resource
Miraie ED
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0022-3476(88)80262-2" target="_blank" rel="noreferrer">10.1016/s0022-3476(88)80262-2</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1988
1988
Adult
Age Factors
Backlog
Brain Diseases
Death and Euthanasia
Diseases
Enteral Nutrition
Euthanasia
Humans
Infant
Journal Article
Jurisprudence
Male
Miraie ED
Morals
Newborn
Parents
Passive
Patient Selection
The Journal Of Pediatrics
Withholding Treatment
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1136/jme.12.2.72" target="_blank" rel="noreferrer">http://doi.org/10.1136/jme.12.2.72</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Informed dissent: the views of some mothers of severely mentally handicapped young adults
Publisher
An entity responsible for making the resource available
Journal Of Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
1986
Subject
The topic of the resource
Female; Humans; infant; Adult; Middle Aged; Euthanasia; Disabled Persons; Informed Consent; Patient Compliance; Empirical Approach; Mental Health Therapies; Death and Euthanasia; Mothers/psychology; Newborn; Genetics and Reproduction; Passive; Value of Life; Abortion; Congenital Abnormalities/therapy; Induced
Creator
An entity primarily responsible for making the resource
Simms M
Description
An account of the resource
Much of the discussion since the Arthur case has centred round the rights of handicapped infants to medical treatment. Little has centred round the question of how far one person can rightly be required to sacrifice her life for another, when she has not been consulted beforehand. This may be due to the fact that most of the discussants are men, while nearly all the carers are women. This small study attempts to redress this balance by asking mothers who have cared for 20 years, whether they felt it was worthwhile.; KIE: As part of a larger study by a British regional health authority, 15 mothers of severely mentally handicapped young adults from varying socioeconomic areas were asked for their views on selective abortion and treatment of severely handicapped newborns. Ten of the 15 women wished with hindsight that they could have had an abortion, and 12 thought such infants should be allowed to die. Simms concludes that the views of those who have cared devotedly for their severely mentally handicapped children deserve more consideration. Davis, herself disabled and an activist for the handicapped, asserts that human rights devolve to every individual at fertilization and cannot be apportioned according to perceived "worth." She suggests that parents who are unable to cope with a handicapped child should consider offering the baby for adoption as an alternative to "killing" the child.
1986
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1136/jme.12.2.72" target="_blank" rel="noreferrer">10.1136/jme.12.2.72</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
1986
Abortion
Adult
Backlog
Congenital Abnormalities/therapy
Death and Euthanasia
Disabled Persons
Empirical Approach
Euthanasia
Female
Genetics and Reproduction
Humans
Induced
Infant
Informed Consent
Journal Article
Journal of Medical Ethics
Mental Health Therapies
Middle Aged
Mothers/psychology
Newborn
Passive
Patient Compliance
Simms M
Value of Life
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.2307/3560572" target="_blank" rel="noreferrer">http://doi.org/10.2307/3560572</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Must patients always be given food and water?
Publisher
An entity responsible for making the resource available
The Hastings Center Report
Date
A point or period of time associated with an event in the lifecycle of the resource
1983
Subject
The topic of the resource
Humans; United States; Withholding Treatment; Social Values; Euthanasia; Risk Assessment; Moral Obligations; Ethics; Parenteral Nutrition; Medical; Death and Euthanasia; Analytical Approach; RDF Project; Passive; Life Support Care/legislation & jurisprudence; Malpractice/legislation & jurisprudence; Philosophical Approach
Creator
An entity primarily responsible for making the resource
Lynn J; Childress JF
Description
An account of the resource
KIE: The widespread consensus that withholding certain life-sustaining treatments, especially those entailing substantial suffering, is sometimes in a patient's best interest conflicts with our basic instincts when the treatments are food and water. Lynn and Childress examine the medical aspects of various nutritional options and the moral obligations pertinent to decision making. They conclude that, in certain limited cases, malnutrition and dehydration need not be corrected and that nutrition and hydration are not distinguishable morally from other life-sustaining treatments that may on occasion be withheld or withdrawn.
1983
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.2307/3560572" target="_blank" rel="noreferrer">10.2307/3560572</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
1983
Analytical Approach
Backlog
Childress JF
Death and Euthanasia
Ethics
Euthanasia
Humans
Journal Article
Life Support Care/legislation & jurisprudence
Lynn J
Malpractice/legislation & jurisprudence
Medical
Moral Obligations
Parenteral Nutrition
Passive
Philosophical Approach
RDF Project
Risk Assessment
Social Values
The Hastings Center Report
United States
Withholding Treatment
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/s0140-6736(05)62952-2" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0140-6736(05)62952-2</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Care for dying patients.
Publisher
An entity responsible for making the resource available
Lancet
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Humans; Palliative Care; Advance Directives; Physician-Patient Relations; Family; Euthanasia; Communication; Physicians; decision making; advance care planning; DNAR; Withholding Treatment; Terminal Care; Passive
Creator
An entity primarily responsible for making the resource
Emanuel EJ
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0140-6736(05)62952-2" target="_blank" rel="noreferrer">10.1016/s0140-6736(05)62952-2</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1997
1997
Advance Care Planning
Advance Directives
Backlog
Communication
Decision Making
DNAR
Emanuel EJ
Euthanasia
Family
Humans
Journal Article
Lancet
Palliative Care
Passive
Physician-patient Relations
Physicians
Terminal Care
Withholding Treatment
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/s0885-3924(00)00212-8" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0885-3924(00)00212-8</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
How children die in hospital.
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Child; Humans; Death; Palliative Care; symptoms; Euthanasia; Communication; Death; Resuscitation Orders; Longitudinal Studies; Critical Care; Children; Children; Preschool; infant; DNAR; Human; Pediatric intensive care unit; Passive; Hospital Mortality; Infant Mortality; Canuck Place 15 year chart review; dying; Infants; Pediatric intensive care unit
Creator
An entity primarily responsible for making the resource
McCallum DE; Byrne P; Bruera E
Description
An account of the resource
A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236 infants and children who died after hospital admission in Edmonton, Canada between January 1996 and June 1998 met entry criteria. Only children who died after a minimum hospitalization of 24 hours in the case of chronic illness or after a minimum hospitalization of 7 days following an acute event were included. Unanticipated deaths were excluded. Eighty-three percent of children died in intensive care settings (64/77), and 78 % (60/77) were intubated prior to their death. Symptoms were recorded in narrative progress notes. Five of 77 (6%) charts contained specific pain assessment and treatment records. Opioid analgesia was provided in 84 % of all cases (65/77). Six (8 %) patients had do not resuscitate (DNNR) orders preceding final hospital admission and 56/71 (79%) remaining patients had documented discussion resulting in DNR decision during final hospital admission. Median time from DNR to death was < 1 day. Mode of death was withdrawal of therapy in 33/77 (43 %), no cardiopulmonary resuscitation (CPR) in 26/77 (34 %), andfailed CPR in 13/77 (17%). Five children were declared brain dead. In only one case was there evidence in the medical record of the possibility of death being discussed explicitly with the patient. Decision-making regarding end-of-life issues in this pediatric population was deferred very close to the time of death, and only after no remaining curative therapy was available. Acuity of care was very high prior to death. Children are rarely told that they are dying.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0885-3924(00)00212-8" target="_blank" rel="noreferrer">10.1016/s0885-3924(00)00212-8</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2000
Backlog
Bruera E
Byrne P
Canuck Place 15 year chart review
Child
Children
Communication
Critical Care
Death
DNAR
Dying
Euthanasia
Hospital Mortality
Human
Humans
Infant
Infant Mortality
Infants
Journal Article
Journal of Pain and Symptom Management
Longitudinal Studies
McCallum DE
Palliative Care
Passive
Pediatric Intensive Care Unit
Preschool
Resuscitation Orders
Symptoms
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1056/nejm200001203420312" target="_blank" rel="noreferrer">http://doi.org/10.1056/nejm200001203420312</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Rethinking the role of tube feeding in patients with advanced dementia
Publisher
An entity responsible for making the resource available
The New England Journal Of Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Humans; United States; Medical Futility; Withholding Treatment; Euthanasia; Religion and Medicine; Risk Assessment; Medical; Mental Health Therapies; Professional Patient Relationship; Death and Euthanasia; decision making; Pneumonia; Psychological; Stress; Legislation; Passive; Empirical Research; Alzheimer Disease/therapy; Aspiration/prevention & control; Dementia/therapy; Enteral Nutrition/adverse effects/standards; 'Physical'; Restraint
Creator
An entity primarily responsible for making the resource
Gillick MR
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1056/nejm200001203420312" target="_blank" rel="noreferrer">10.1056/nejm200001203420312</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2000
'Physical'
2000
Alzheimer Disease/therapy
Aspiration/prevention & control
Backlog
Death and Euthanasia
Decision Making
Dementia/therapy
Empirical Research
Enteral Nutrition/adverse effects/standards
Euthanasia
Gillick MR
Humans
Journal Article
Legislation
Medical
Medical Futility
Mental Health Therapies
Passive
Pneumonia
Professional Patient Relationship
Psychological
Religion and Medicine
Restraint
Risk Assessment
Stress
The New England Journal Of Medicine
United States
Withholding Treatment
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1089/109662101753381692" target="_blank" rel="noreferrer">http://doi.org/10.1089/109662101753381692</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Pediatric extubation: "pulling the tube"
Publisher
An entity responsible for making the resource available
Journal Of Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Humans; infant; Intensive Care Units; Euthanasia; Patient Care Planning; Neonatal; decision making; Newborn; hospice care; Patient Transfer; Intratracheal; Intubation; Passive; Pediatrics/standards
Creator
An entity primarily responsible for making the resource
Sine D; Sumner L; Gracy D; von Gunten CF
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1089/109662101753381692" target="_blank" rel="noreferrer">10.1089/109662101753381692</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2001
2001
Backlog
Decision Making
Euthanasia
Gracy D
Hospice Care
Humans
Infant
Intensive Care Units
Intratracheal
Intubation
Journal Article
Journal of Palliative Medicine
Neonatal
Newborn
Passive
Patient Care Planning
Patient Transfer
Pediatrics/standards
Sine D
Sumner L
von Gunten CF
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/00003246-199703000-00011" target="_blank" rel="noreferrer">http://doi.org/10.1097/00003246-199703000-00011</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Factors explaining variability among caregivers in the intent to restrict life-support interventions in a pediatric intensive care unit
Publisher
An entity responsible for making the resource available
Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Child; Cross-Sectional Studies; Humans; Intensive Care Units; Adult; Attitude of Health Personnel; Medical Staff; Prognosis; Questionnaires; Euthanasia; Life Support Care; Activities of Daily Living; Linear Models; Nursing Staff; Pediatric; Empirical Approach; Professional Patient Relationship; Death and Euthanasia; decision making; Family/psychology; ICU Decision Making; Intervention; Interventions; Passive; Hospital/psychology
Creator
An entity primarily responsible for making the resource
Randolph AG; Zollo MB; Wigton RS; Yeh TS
Description
An account of the resource
OBJECTIVE: To explore patient-related factors which influence the decisions of pediatric intensive care unit (ICU) caregivers to restrict life-support interventions. DESIGN: Cross-sectional survey. SETTING: A university-affiliated pediatric ICU. SUBJECTS: All physicians and nurses caring for oncology or cardiology ICU patients. INTERVENTIONS: Seven patient characteristics were systematically presented in 16 theoretical case scenarios. MEASUREMENTS AND MAIN RESULTS: Individual linear regression models were constructed for each participant by calculating the importance caregivers placed on seven patient characteristics when deciding about starting intravenous vasopressors, performing chest compressions, and withdrawing life support. We compared the numerical and descriptive (very low, low, moderate, high) probability of survival. We surveyed 86 caregivers and 56 (65%) responded. The most important factors influencing decisions were family preferences (76% of decisions), followed by probability of survival (50%), and functional status (47%). There was marked variability among respondents in 38 (79%)/48 of the questions; 20% to 50% of caregivers chose opposing directions of patient management when they were asked to indicate the likelihood that they would perform a specific life-support intervention. The same term was never used by all respondents to describe the probability of survival for a scenario. CONCLUSION: Critically ill children and their families could face markedly different attitudes about the restriction of life-support interventions, depending on which nurses and physicians are involved in their care.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00003246-199703000-00011" target="_blank" rel="noreferrer">10.1097/00003246-199703000-00011</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
1997
Activities of Daily Living
Adult
Attitude Of Health Personnel
Backlog
Child
Critical Care Medicine
Cross-sectional Studies
Death and Euthanasia
Decision Making
Empirical Approach
Euthanasia
Family/psychology
Hospital/psychology
Humans
ICU Decision Making
Intensive Care Units
Intervention
Interventions
Journal Article
Life Support Care
Linear Models
Medical Staff
Nursing Staff
Passive
Pediatric
Professional Patient Relationship
Prognosis
Questionnaires
Randolph AG
Wigton RS
Yeh TS
Zollo MB
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/00003246-200110000-00007" target="_blank" rel="noreferrer">http://doi.org/10.1097/00003246-200110000-00007</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity
Publisher
An entity responsible for making the resource available
Critical Care Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Female; Humans; Male; Intensive Care Units; Prevalence; Logistic Models; Questionnaires; Prospective Studies; Euthanasia; Multivariate Analysis; Ethics; Medical; decision making; Family/psychology; Nonparametric; Statistics; Life Support Care/utilization; Passive; Critical Illness/therapy; Anxiety/epidemiology/etiology; Depressive Disorder/epidemiology/etiology; France/epidemiology
Creator
An entity primarily responsible for making the resource
Pochard F; Azoulay E; Chevret S; Lemaire F; Hubert P; Canoui P; Grassin M; Zittoun R; LeGall JR; Dhainaut JF; Schlemmer B; Group French FAMIREA
Description
An account of the resource
OBJECTIVE: Anxiety and depression may have a major impact on a person's ability to make decisions. Characterization of symptoms that reflect anxiety and depression in family members visiting intensive care patients should be of major relevance to the ethics of involving family members in decision-making, particularly about end-of-life issues. DESIGN: Prospective multicenter study. SETTING: Forty-three French intensive care units (37 adult and six pediatric); each unit included 15 patients admitted for longer than 2 days. PATIENTS: Six hundred thirty-seven patients and 920 family members. INTERVENTIONS: Intensive care unit characteristics and data on the patient and family members were collected. Family members completed the Hospital Anxiety and Depression Scale to allow evaluation of the prevalence and potential factors associated with symptoms of anxiety and depression. MEASUREMENTS AND MAIN RESULTS: Of 920 Hospital Anxiety and Depression Scale questionnaires that were completed by family members, all items were completed in 836 questionnaires, which formed the basis for this study. The prevalence of symptoms of anxiety and depression in family members was 69.1% and 35.4%, respectively. Symptoms of anxiety or depression were present in 72.7% of family members and 84% of spouses. Factors associated with symptoms of anxiety in a multivariate model included patient-related factors (absence of chronic disease), family-related factors (spouse, female gender, desire for professional psychological help, help being received by general practitioner), and caregiver-related factors (absence of regular physician and nurse meetings, absence of a room used only for meetings with family members). The multivariate model also identified three groups of factors associated with symptoms of depression: patient-related (age), family-related (spouse, female gender, not of French descent), and caregiver-related (no waiting room, perceived contradictions in the information provided by caregivers). CONCLUSIONS: More than two-thirds of family members visiting patients in the intensive care unit suffer from symptoms of anxiety or depression. Involvement of anxious or depressed family members in end-of-life decisions should be carefully discussed.
2001
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00003246-200110000-00007" target="_blank" rel="noreferrer">10.1097/00003246-200110000-00007</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
2001
Anxiety/epidemiology/etiology
Azoulay E
Backlog
Canoui P
Chevret S
Critical Care Medicine
Critical Illness/therapy
Decision Making
Depressive Disorder/epidemiology/etiology
Dhainaut JF
Ethics
Euthanasia
Family/psychology
Female
France/epidemiology
Grassin M
Group French FAMIREA
Hubert P
Humans
Intensive Care Units
Journal Article
LeGall JR
Lemaire F
Life Support Care/utilization
Logistic Models
Male
Medical
Multivariate Analysis
Nonparametric
Passive
Pochard F
Prevalence
Prospective Studies
Questionnaires
Schlemmer B
Statistics
Zittoun R
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/00006254-199706000-00009" target="_blank" rel="noreferrer">http://doi.org/10.1097/00006254-199706000-00009</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Death in the intensive care nursery: physician practice of withdrawing and withholding life support
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Humans; infant; Intensive Care Units; Medical Futility; Euthanasia; Life Support Care; quality of life; Pediatric; Empirical Approach; Death and Euthanasia; decision making; Newborn; ICU Decision Making; Very Low Birth Weight; Passive; San Francisco; Life Support Systems; University of California
Creator
An entity primarily responsible for making the resource
Wall SN; Partridge JC
Description
An account of the resource
OBJECTIVE: To determine the frequency of selective nontreatment of extremely premature, critically ill, or malformed infants among all infant deaths in a level III intensive care nursery (ICN) and to determine the reasons documented by neonatologists for their decisions to withdraw or withhold life support. METHODS: This was a descriptive study based on review of the medical records of all 165 infants who died at a university-based level III ICN during 3 years. We determined whether each death had occurred despite the use of all available technologies to keep the infant alive or whether these were withheld or withdrawn, thereby leading to the infant's death. We also determined whether neonatologists documented either "futility" or "quality of life" as a reason to limit medical interventions. RESULTS: One hundred sixty-five infants died among the 1609 infants admitted during the study period. One hundred eight infant deaths followed the withdrawal of life support, 13 deaths followed the withholding of treatment, and 44 deaths occurred while infants continued to receive maximal life-sustaining treatment. For 90 (74%) of the 121 deaths attributable to withholding of withdrawal of treatment, physicians cited that death was imminent and treatment was futile. Quality-of-life concerns were cited by the neonatologists as reasons to limit treatment in 62 (51%). Quality of life was the only reason cited for limiting treatment for 28 (23%) of the 121 deaths attributable to withholding or withdrawal of treatment. CONCLUSIONS: The majority of deaths in the ICN occurred as a result of selective nontreatment by neonatologists, with few infants receiving maximal support until the actual time of death. Neonatologists often documented that quality-of-life concerns were considered in decisions to limit treatment; however, the majority of these decisions were based on their belief that treatment was futile. Prospective studies are needed to elucidate the determinants of neonatologists' practice decisions of selective nontreatment for marginally viable or damaged infants.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00006254-199706000-00009" target="_blank" rel="noreferrer">10.1097/00006254-199706000-00009</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
1997
Backlog
Death and Euthanasia
Decision Making
Empirical Approach
Euthanasia
Humans
ICU Decision Making
Infant
Intensive Care Units
Journal Article
Life Support Care
Life Support Systems
Medical Futility
Newborn
Partridge JC
Passive
Pediatric
Pediatrics
Quality Of Life
San Francisco
University of California
Very Low Birth Weight
Wall SN
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1136/bmj.311.7003.464" target="_blank" rel="noreferrer">http://doi.org/10.1136/bmj.311.7003.464</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Withdrawing artificial feeding from children with brain damage
Publisher
An entity responsible for making the resource available
Bmj (clinical Research Ed.)
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
Subject
The topic of the resource
Child; Humans; Withholding Treatment; Treatment Refusal; Euthanasia; Enteral Nutrition; Ethics; Medical; Preschool; Death and Euthanasia; Brain Diseases; Brain Damage; Chronic; Passive; Persistent Vegetative State
Creator
An entity primarily responsible for making the resource
Cranford R
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1136/bmj.311.7003.464" target="_blank" rel="noreferrer">10.1136/bmj.311.7003.464</a>
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1995
1995
Backlog
Bmj (clinical Research Ed.)
Brain Damage
Brain Diseases
Child
Chronic
Cranford R
Death and Euthanasia
Enteral Nutrition
Ethics
Euthanasia
Humans
Journal Article
Medical
Passive
Persistent Vegetative State
Preschool
Treatment Refusal
Withholding Treatment
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10474691" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10474691</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Lessons learned and not learned from the SUPPORT project
Publisher
An entity responsible for making the resource available
Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1999
Subject
The topic of the resource
Hospitalization; Adult; Euthanasia; Health Care Costs; quality of life; Randomized Controlled Trials; Human; decision making; Terminally Ill; Passive
Creator
An entity primarily responsible for making the resource
Teno JM
Rights
Information about rights held in and over the resource
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).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1999
1999
Adult
Backlog
Decision Making
Euthanasia
Health Care Costs
Hospitalization
Human
Journal Article
Palliative Medicine
Passive
Quality Of Life
Randomized Controlled Trials
Teno JM
Terminally Ill