[French law related to patient's rights and end of life: pediatric intensive care unit's health professionals' opinions]
Child; Humans; Intensive Care Units; Palliative Care; patient care team; Terminal Care; Attitude of Health Personnel; Withholding Treatment; Resuscitation Orders; Double Effect Principle; Suicide; Patient Rights; Pediatric; Health Surveys; France; Assisted; Health Care; Quality Assurance
INTRODUCTION AND OBJECTIVES: To identify the knowledge of caregivers of pediatric intensive care units (PICUs) on the French law related to patients' rights and end of life, their views on withholding/withdrawing life-sustaining treatment (WWLST) decisions, and their feelings about how these decisions were made and implemented. MATERIALS AND METHODS: A multicenter survey in 24 French PICUs during the fourth trimester 2010. RESULTS: One thousand three hundred and thirty-nine professional healthcare workers (1005 paramedics and 334 physicians) responded. Over 85% of caregivers had good knowledge of the WWLST decision-making processes required by law. More than 80% of caregivers accepted mechanical ventilation, hemodiafiltration, or hemodynamic support withdrawal or withholding. Nevertheless, the withdrawal of artificial nutrition and hydration generated reluctance or opposition for the majority of respondents. While paramedics' participation in the decision-making process was deemed necessary by all caregivers, paramedics found more often than physicians that they were insufficiently involved. The quality of end-of-life care was judged very positively by caregivers. The answers on how WWLST was applied suggest very different interpretations of the law. Some caregivers respect the principles of palliative care as stated in the public health code and 40% of doctors and 64% of caregivers consider it "acceptable" to hasten death if resulting from a collaborative decision-making process. CONCLUSION: This study is the first to show that caregivers of French PICUs have good knowledge of the French law concerning the end of life. Yet, there is still confusion about the limits of practice during the end-of-life period.
2014-01
de Saint Blanquat L; Cremer R; Elie C; Lesage F; Dupic L; Hubert P; pour le Groupe francophone de réanimation et urgences pédiatriques (GFRUP)
Archives De Pediatrie
2014
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).
Journal Article
<a href="http://doi.org/10.1016/j.arcped.2013.10.018" target="_blank" rel="noreferrer">10.1016/j.arcped.2013.10.018</a>
Self-requested euthanasia for children in Belgium
Humans; Young Adult; Palliative Care; Mental Competency; Personal Autonomy; Euthanasia; Choice Behavior; Minors; Europe; Belgium; Patient Rights; quality of life; adolescent; decision making; Active; Voluntary; Wedge Argument
In the complex patient—doctor relationship, the principle of personal autonomy has gradually acquired more weight against medical paternalism, both in clinical practice and in bioethical thinking. 1 In many countries, this change has been incorporated into national legislation in the past 20 years. The Belgian Act on Patients' Rights was promulgated in 2002. In the same year, the Belgian Act on Palliative Care was adopted, which grants access to palliative care that focuses on improving quality of ...
2014-02
Dan B; Fonteyne C; de Cléty Stéphan Clément
Lancet
2014
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).
Journal Article
<a href="http://doi.org/10.1016/S0140-6736(14)60110-0" target="_blank" rel="noreferrer">10.1016/S0140-6736(14)60110-0</a>
Rights of the child: to die?
Child; Humans; Terminally Ill; Euthanasia; Child Advocacy; Europe; Patient Rights
The legal position of the child as a vulnerable individual requires us as a society to treat them with special consideration in regard to the sanctity of life. In UK law, euthanasia is currently illegal, although there are some moves afoot to have this changed for those who have reached majority (18 years of age in the UK).
2014-04
Gormley-Fleming Liz; Campbell A
British Journal Of Nursing
2014
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).
Journal Article
<a href="http://doi.org/10.12968/bjon.2014.23.6.302" target="_blank" rel="noreferrer">10.12968/bjon.2014.23.6.302</a>
Medical ethics in pediatric critical care
Child; Humans; United States; Terminal Care; decision making; Parental Consent; Personal Autonomy; Pediatrics; Withholding Treatment; Professional-Family Relations; Dissent and Disputes; Truth Disclosure; Critical Care; Tissue and Organ Procurement; Ethics; Medical; Patient Rights; Clinical; Ethics Committees; Resource Allocation
Ethically charged situations are common in pediatric critical care. Most situations can be managed with minimal controversy within the medical team or between the team and patients/families. Familiarity with institutional resources, such as hospital ethics committees, and national guidelines, such as publications from the American Academy of Pediatrics, American Medical Association, or Society of Critical Care Medicine, are an essential part of the toolkit of any intensivist. Open discussion with colleagues and within the multidisciplinary team can also ensure that when difficult situations arise, they are addressed in a proactive, evidence-based, and collegial manner.
2013-04
Orioles A; Morrison WE
Critical Care Clinics
2013
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).
Journal Article
<a href="http://doi.org/10.1016/j.ccc.2012.12.002" target="_blank" rel="noreferrer">10.1016/j.ccc.2012.12.002</a>
Appropriate use of artificial nutrition and hydration--fundamental principles and recommendations
Humans; United States; Palliative Care; Advance Directives; Ethics; Third-Party Consent; Patient Rights; Clinical; Life Support Care/ethics; Nutritional Support/adverse effects/ethics; Withholding Treatment/ethics
2005
Casarett D; Kapo J; Caplan A
The New England Journal Of Medicine
2005
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).
Journal Article
<a href="http://doi.org/10.1056/NEJMsb052907" target="_blank" rel="noreferrer">10.1056/NEJMsb052907</a>
Nurses' attitudes to pain management during routine venepuncture in young children
Child; Humans; Pain Measurement; Questionnaires; Age Factors; Severity of Illness Index; Nursing Assessment; Nursing Methodology Research; Child Advocacy; Nursing Staff; Patient Rights; Practice; Preschool; Attitudes; PedPal Lit; infant; Health Knowledge; Hospitalized/psychology; Child; Nurse's Role/psychology; Attitude of Health Personnel; administration/psychology; Hospital/education/organization &; Pain/diagnosis/etiology/prevention & control/psychology; Pediatric Nursing/education/organization & administration; Phlebotomy/adverse effects
Venepuncture is one of the most commonly performed clinical procedures carried out on young children. Evidence indicates inconsistency in the use of pain management strategies during these procedures. A survey method was used to explore nurses' views on the experience of pain by infants and toddlers and the pain management techniques they use. All children's nurses on the general medical and surgical wards at one hospital site were invited to participate (n=55)
45 responses were receive (81 per cent). These children's nurses believe that infants and toddlers feel more pain and display more distress than older children. Respondents reported that pharmacological preparations were not generally used on infants prior to venous cannulation
Melhuish S; Payne H
Paediatric Nursing
2006
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).
Journal Article