1
40
44
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Title
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March 2024 List
Text
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March List 2024
URL Address
<a href="http://doi.org/10.1016/j.arcped.2023.10.004" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1016/j.arcped.2023.10.004</a>
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Parents' participation in collegial meetings to discuss withholding or withdrawing treatment for their newborn: Working to improve information-sharing
Publisher
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Archives de Pediatrie
Date
A point or period of time associated with an event in the lifecycle of the resource
2024
Subject
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decision making; life sustaining treatment; parent; adult; advisory committee; child; conference paper; female; follow up; grief; human; Infant Newborn; Information Dissemination; newborn; refusal to participate; retrospective study; terminal care; Withholding Treatment
Creator
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Boize P; Garner Y; Neaud E; Borrhomee S
Description
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Aim: The role of parents in decision-making concerning their child's end-of-life care is not clearly defined. Their participation is encouraged by ethical reflection, in particular by the CCNE (French National Ethics Advisory Committee), but laws are limited to imposing a duty to provide information to doctors. Decisions are taken at the end of a collegial meeting (CM) intended to better inform the child's referring physician (RP) who is in charge of the final decision following the French law. The aim of this study was to describe the support provided to bereaved families after they had been invited to attend a CM concerning their child, if they so wished. Additional aims were to determine the differences resulting from their acceptance or their refusal to participate as regards their perception of their child's history and as regards their grieving process. Material and method: We conducted a retrospective study of all CMs held between November 2016 and May 2021, drawing a distinction between proposals made or not made to parents and their decision to accept or refuse. Results: In total, 49 CMs concerning 46 children were held during the study period. The proposal was not made to the parents in three cases; the parents chose to be present in 28 cases. The psychological follow-up (15/28 parents attending, 10/16 parents absent) illustrated that their presence enabled them to reflect on their child's death after having listened to and understood the reasons why it happened. They did not dispute the team's approach or decisions taken. Conclusion: It is possible to include parents in CMs if they so wish. It would appear more beneficial than merely providing them with the information required. Studies must be carried out to ensure potential long-term benefit.
Identifier
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<a href="http://doi.org/10.1016/j.arcped.2023.10.004" target="_blank" rel="noreferrer noopener">10.1016/j.arcped.2023.10.004</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).
2024
Adult
advisory committee
Archives de Pediatrie
Boize P
Borrhomee S
Child
Conference Paper
Decision Making
Female
Follow Up
Garner Y
Grief
Human
Infant Newborn
Information Dissemination
Life Sustaining Treatment
March List 2024
Neaud E
Newborn
Parent
Refusal To Participate
Retrospective Study
Terminal Care
Withholding Treatment
-
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Title
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August 2023 List
Text
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August List 2023
URL Address
<a href="http://doi.org/10.5546/aap.2022-02872.eng" target="_blank" rel="noreferrer noopener"> http://doi.org/10.5546/aap.2022-02872.eng</a>
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Decisions concerning resuscitation and end-of-life care in neonates. Bioethical aspects (Part II)
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Archivos Argentinos de Pediatria
Date
A point or period of time associated with an event in the lifecycle of the resource
2023
Subject
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Humans; Infant, Newborn; Infant; Decision Making; Terminal Care; Withholding Treatment; Medical Futility; Bioethics; Terminal Care; Death; Resuscitation
Creator
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Mariani G; Arimany M
Description
An account of the resource
Coping with the death of a newborn infant requires training and reflection regarding the end-of-life decision-making process, communication with the family, and the care to be provided. The objective of this article is to analyze in depth the salient aspects of neonatal bioethics applied to end-of-life situations in newborn infants. Part I describes notions of therapeutic futility, redirection of care criteria, patient and family rights, and concepts about the value of life. Part II analyzes situations that deserve considering the redirection of care and delves into aspects of communication and the complex process of end-of-life decision-making in newborn infants.
Identifier
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<a href="http://doi.org/10.5546/aap.2022-02872.eng" target="_blank" rel="noreferrer noopener">10.5546/aap.2022-02872.eng</a>
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2023
Archivos Argentinos De Pediatria
Arimany M
August List 2039
Bioethics
Death
Decision Making
Humans
Infant
Infant, Newborn
Mariani G
Medical Futility
Resuscitation
Terminal Care
Withholding Treatment
-
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Title
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August 2022 List
Text
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August 2022 List
URL Address
<a href="http://doi.org/10.1016/j.semperi.2021.151525" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.semperi.2021.151525</a>
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Moral equivalence theory in neonatology
Publisher
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Seminars in Perinatology
Date
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2022
Subject
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Humans; Decision Making; Infant, Newborn; Withholding Treatment; Morals; Neonatology
Creator
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Lin M; Vitcov GG; Cummings CL
Description
An account of the resource
This article explores the ethical concept of "the equivalence thesis" (ET), or the idea that withdrawing and withholding life sustaining treatments are morally equivalent practices, within neonatology. We review the historical origins, theory, and clinical rationale behind ET, and provide an analysis of how ET relates to literature that describes neonatal mode of death and healthcare professional and parent attitudes towards end-of-life care. While ET may serve as an ethical tool to optimize resource allocation in theory, its clinical utility is limited given the complexity of end-of-life care decisions.
Identifier
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<a href="http://doi.org/10.1016/j.semperi.2021.151525" target="_blank" rel="noreferrer noopener">10.1016/j.semperi.2021.151525</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).
2022
August 2022 List
Cummings CL
Decision Making
Humans
Infant, Newborn
Lin M
Morals
Neonatology
Seminars in Perinatology
Vitcov GG
Withholding Treatment
-
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Title
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February 2021 List
Text
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February 2021 List
URL Address
<a href="http://doi.org/10.1007/s11017-020-09532-x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/s11017-020-09532-x</a>
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Valuing life and evaluating suffering in infants with life-limiting illness
Publisher
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Theoretical Medicine and Bioethics
Date
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2020
Subject
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Quality of life; Withholding treatment; Cognition disorders; Infancy; Newborns; Value of life
Creator
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Wilkinson D; Zayegh A
Description
An account of the resource
In this paper, we explore three separate questions that are relevant to assessing the prudential value of life in infants with severe life-limiting illness. First, what is the value or disvalue of a short life? Is it in the interests of a child to save her life if she will nevertheless die in infancy or very early childhood? Second, how does profound cognitive impairment affect the balance of positives and negatives in a child's future life? Third, if the life of a child with life-limiting illness is prolonged, how much suffering will she experience and can any of it be alleviated? Is there a risk that negative experiences for such a child (suffering) will remain despite the provision of palliative care? We argue that both the subjective and objective components of well-being for children could be greatly reduced if they are anticipated to have a short life that is affected by profound cognitive impairment. This does not mean that their overall well-being will be negative, but rather that there may be a higher risk of negative overall well-being if they are expected to experience pain, discomfort, or distress. Furthermore, we point to some of the practical limitations of therapies aimed at relieving suffering, such that there is a risk that suffering will go partially or completely unrelieved. Taken together, these considerations imply that some life-prolonging treatments are not in the best interests of infants with severe life-limiting illness.
Identifier
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<a href="http://doi.org/10.1007/s11017-020-09532-x" target="_blank" rel="noreferrer noopener">10.1007/s11017-020-09532-x</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).
2020
Cognition Disorders
February 2021 List
Infancy
Newborns
Quality Of Life
Theoretical Medicine and Bioethics
Value of Life
Wilkinson D
Withholding Treatment
Zayegh A
-
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Title
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January 2021 List
Text
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Citation List Month
January 2021 List
URL Address
<a href="http://doi.org/10.1186/s12910-020-00555-6" target="_blank" rel="noreferrer noopener">http://doi.org/10.1186/s12910-020-00555-6</a>
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Physicians' attitudes in relation to end-of-life decisions in Neonatal Intensive Care Units: a national multicenter survey
Publisher
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BMC Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
Subject
The topic of the resource
End-of-life care; Attitude; Neonates; Withdrawing treatment; Neonatal Intensive Care Units; Withholding treatment
Creator
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Chatziioannidis I; Iliodromiti Z; Boutsikou T; Pouliakis A; Giougi E; Sokou R; Vidalis T; Xanthos T; Marina C; Iacovidou N
Description
An account of the resource
BACKGROUND: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians' profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensive Care Units and correlate them with self-reported practices of end-of-life decisions and with their background data. METHODS: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians' attitude and views ranging from value of life to quality of life approach (scale 1-5). RESULTS: Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians' educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p < 0.001) were factors that affected the attitude score. CONCLUSIONS: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.
Identifier
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<a href="http://doi.org/10.1186/s12910-020-00555-6" target="_blank" rel="noreferrer noopener">10.1186/s12910-020-00555-6</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).
2020
Attitude
Bmc Medical Ethics
Boutsikou T
Chatziioannidis I
End-of-life Care
Giougi E
Iacovidou N
Iliodromiti Z
January 2021 List
Marina C
Neonatal Intensive Care Units
Neonates
Pouliakis A
Sokou R
Vidalis T
Withdrawing Treatment
Withholding Treatment
Xanthos T
-
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Title
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December 2020 List
Text
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Citation List Month
December 2020 List
URL Address
<a href="http://doi.org/10.1542/peds.2020-0818L" target="_blank" rel="noreferrer noopener">http://doi.org/10.1542/peds.2020-0818L</a>
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Reflections on charlie gard and the best interests standard from both sides of the atlantic ocean
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
Subject
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Clinical Decision-Making/ethics; patient advocacy; patient transfer/ethics; withholding treatment
Creator
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Ross LF
Description
An account of the resource
Charlie Gard (August 4, 2016, to July 28, 2017) was an infant in the United Kingdom who was diagnosed with an encephalopathic form of mitochondrial DNA depletion syndrome caused by a mutation in the RRM2B gene. Charlie's parents raised 1.3 million (~$1.6 million US) on a crowdfunding platform to travel to New York to pursue experimental nucleoside bypass treatment, which was being used to treat a myopathic form of mitochondrial DNA depletion syndrome caused by mutations in a different gene (TK2). The case made international headlines about what was in Charlie's best interest. In the medical ethics community, it raised the question of whether best interest serves as a guidance principle (a principle that provides substantive directions as to how decisions are to be made), an intervention principle (a principle specifying the conditions under which third parties are to intervene), both guidance and intervention, or neither. I show that the United Kingdom uses best interest as both guidance and intervention, and the United States uses best interest for neither. This explains why the decision to withdraw the ventilator without attempting nucleoside bypass treatment was the correct decision in the United Kingdom and why the opposite conclusion would have been reached in the United States. Copyright © 2020 by the American Academy of Pediatrics
Identifier
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<a href="http://doi.org/10.1542/peds.2020-0818L" target="_blank" rel="noreferrer noopener">10.1542/peds.2020-0818L</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).
2020
Clinical Decision-Making/ethics
December 2020 List
Patient Advocacy
patient transfer/ethics
Pediatrics
Ross LF
Withholding Treatment
-
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Title
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August 2020 List
Text
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Citation List Month
August 2020 List
URL Address
<a href="http://doi.org/10.1186/s12904-020-00575-4" target="_blank" rel="noreferrer noopener">http://doi.org/10.1186/s12904-020-00575-4</a>
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End-of-life care in a pediatric intensive care unit: The impact of the development of a palliative care unit
Publisher
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BMC Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2020
Subject
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palliative care; pediatric intensive care unit; hospital mortality; withholding treatment; withdrawal
Creator
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Bobillo-Perez S; Segura S; Girona-Alarcon M; Felipe A; Balaguer M; Hernandez-Platero L; Sole-Ribalta A; Guitart C; Jordan I; Cambra F J
Description
An account of the resource
Background: The purpose of this paper is to describe how end-of-life care is managed when life-support limitation is decided in a Pediatric Intensive Care Unit and to analyze the influence of the further development of the Palliative Care Unit. Method(s): A 15-year retrospective study of children who died after life-support limitation was initiated in a pediatric intensive care unit. Patients were divided into two groups, pre- and post-palliative care unit development. Epidemiological and clinical data, the decision-making process, and the approach were analyzed. Data was obtained from patient medical records. Result(s): One hundred seventy-five patients were included. The main reason for admission was respiratory failure (86/175). A previous pathology was present in 152 patients (61/152 were neurological issues). The medical team and family participated together in the decision-making in 145 cases (82.8%). The family made the request in 10 cases (9 vs. 1, p = 0.019). Withdrawal was the main life-support limitation (113/175), followed by withholding life-sustaining treatments (37/175). Withdrawal was more frequent in the post-palliative group (57.4% vs. 74.3%, p = 0.031). In absolute numbers, respiratory support was the main type of support withdrawn. Conclusion(s): The main cause of life-support limitation was the unfavourable evolution of the underlying pathology. Families were involved in the decision-making process in a high percentage of the cases. The development of the Palliative Care Unit changed life-support limitation in our unit, with differences detected in the type of patient and in the strategy used. Increased confidence among intensivists when providing end-of-life care, and the availability of a Palliative Care Unit may contribute to improvements in the quality of end-of-life care. Copyright © 2020 The Author(s).
Identifier
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<a href="http://doi.org/10.1186/s12904-020-00575-4" target="_blank" rel="noreferrer noopener">10.1186/s12904-020-00575-4</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).
2020
August 2020 List
Balaguer M
BMC Palliative Care
Bobillo-Perez S
Cambra F J
Felipe A
Girona-Alarcon M
Guitart C
Hernandez-Platero L
Hospital Mortality
Jordan I
Palliative Care
Pediatric Intensive Care Unit
Segura S
Sole-Ribalta A
Withdrawal
Withholding Treatment
-
Dublin Core
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Title
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January 2020 List
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
January 2020 List
URL Address
<a href="https://www.ncbi.nlm.nih.gov/pubmed/31682350">https://www.ncbi.nlm.nih.gov/pubmed/31682350</a>
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Title
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An Objective Approach to Decisions to Withdraw or Withhold Life-sustaining Medical Treatment
Publisher
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Journal of Law and Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
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Australia; best interests; child; Child; Decision Making; England; futility; Humans; life-sustaining treatment; New Zealand; parens patriae; Preschool; Wales; withdrawing treatment; withholding treatment; Withholding Treatment
Creator
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Savulescu J; Cameron J
Description
An account of the resource
Courts in England and Wales, Australia, and New Zealand have insisted the question of when it is acceptable to withdraw or withhold life-sustaining medical treatment from a child must be considered on a case-by-case basis. Over the last 40 years a number of cases have considered whether treatment is objectively in the child's best interests. This article seeks to identify whether there are factors identified and weighed in a consistent manner across cases. Thirty cases involving decisions about the provision of life-sustaining medical treatment to children three years old or younger were identified. Judges regularly refer to the need to weigh benefits and burdens and these factors were identified and assigned scores. Eight key factors were identified, and a scoring range was assigned to each. The factors focus on the condition and position of the child and the burdens of invasive medical treatment. The review demonstrates there are factors consistently identified and despite criticisms of the indeterminacy of the best interests test, there may be a broadly consistent approach to decision-making. Cognitive capacity and unavoidably imminent death appear to be the two most influential factors in determining whether life-sustaining treatment should be provided.
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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).
2019
Australia
best interests
Cameron J
Child
Decision Making
England
Futility
Humans
January 2020 List
Journal of law and medicine
life-sustaining treatment
New Zealand
parens patriae
Preschool
Savulescu J
Wales
Withdrawing Treatment
Withholding Treatment
-
Dublin Core
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Title
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November 2018 List
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
November 2018 List
URL Address
<a href="http://doi.org/10.1177/1049909117743474" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/1049909117743474</a>
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Title
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Life-Sustaining Treatment Status at the Time of Death in a Japanese Pediatric Intensive Care Unit
Publisher
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American Journal of Hospice & Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
Subject
The topic of the resource
decision making;Intensive Care Units;Life Support Care;Terminal Care sn [Statistics & Numerical Data];Adolescent;Artificial;Brain Death di [Diagnosis];Child;Female;Humans;Length of Stay;Life Support Care;Male;Pediatric sn [Statistics & Numerical Data];Preschool;Respiration;Resuscitation Orders;Retrospective Studies;Terminal Care px [Psychology];Time Factors;Withholding Treatment
Creator
An entity primarily responsible for making the resource
Suzuki F;Takeuchi M;Tachibana K;Isaka K;Inata Y;Kinouchi K
Description
An account of the resource
BACKGROUND: Substantial variability exists among countries regarding the modes of death in pediatric intensive care units (PICUs). However, there is limited information on end-of-life care in Japanese PICUs. Thus, this study aimed to elucidate the characteristics of end-of-life care practice for children in a Japanese PICU. METHODS: We examined life-sustaining treatment (LST) status at the time of death based on medical chart reviews from 2010 to 2014. All deaths were classified into 3 groups: limitation of LST (limitation group, death after withholding or withdrawal of LST or a do not attempt resuscitation order), no limitation of LST (no-limitation group, death following failed resuscitation attempts), or brain death (brain death group). RESULTS: Of the 62 patients who died, 44 (71%) had limitation of LST, 18 (29%) had no limitation of LST, and none had brain death. In the limitation group, the length of PICU stay was longer than that in the no-limitation group (13.5 vs 2.5 days; P = .01). The median time to death after the decision to limit LST was 2 days (interquartile range: 1-5.5 days), and 94% of the patients were on mechanical ventilation at the time of death in the limitation group. CONCLUSIONS: Although limiting LST was a common practice in end-of-life care in a Japanese PICU, a severe limitation of LST such as withdrawal from the ventilator was hardly practiced, and a considerable LST was still provided at the time of death.
Identifier
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<a href="http://doi.org/10.1177/1049909117743474" target="_blank" rel="noreferrer noopener">10.1177/1049909117743474</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).
2018
Adolescent
American Journal of Hospice & Palliative Medicine
Artificial
Brain Death di [Diagnosis]
Child
Decision Making
Female
Humans
Inata Y
Intensive Care Units
Isaka K
Kinouchi K
Length Of Stay
Life Support Care
Male
November 2018 List
Pediatric sn [Statistics & Numerical Data]
Preschool
Respiration
Resuscitation Orders
Retrospective Studies
Suzuki F
Tachibana K
Takeuchi M
Terminal Care px [Psychology]
Terminal Care sn [Statistics & Numerical Data]
Time Factors
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/j.arcped.2013.10.018" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.arcped.2013.10.018</a>
Dublin Core
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Title
A name given to the resource
[French law related to patient's rights and end of life: pediatric intensive care unit's health professionals' opinions]
Publisher
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Archives De Pediatrie
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; 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
Creator
An entity primarily responsible for making the resource
de Saint Blanquat L; Cremer R; Elie C; Lesage F; Dupic L; Hubert P; pour le Groupe francophone de réanimation et urgences pédiatriques (GFRUP)
Description
An account of the resource
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
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.arcped.2013.10.018" target="_blank" rel="noreferrer">10.1016/j.arcped.2013.10.018</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
Archives de Pediatrie
Assisted
Attitude Of Health Personnel
Backlog
Child
Cremer R
de Saint Blanquat L
Double Effect Principle
Dupic L
Elie C
France
Health Care
Health Surveys
Hubert P
Humans
Intensive Care Units
Journal Article
Lesage F
Palliative Care
Patient Care Team
Patient Rights
Pediatric
pour le Groupe francophone de réanimation et urgences pédiatriques (GFRUP)
Quality Assurance
Resuscitation Orders
Suicide
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/10.1542/peds.2013-3608B" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2013-3608B</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 palliative care and pediatric medical ethics: opportunities and challenges
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
adolescent; Child; Humans; infant; Pediatrics; Withholding Treatment; Communication; Resuscitation Orders; Ethics; Medical; Palliative Care; 20th Century; History
Creator
An entity primarily responsible for making the resource
Feudtner C; Nathanson PG
Description
An account of the resource
The fields of pediatric palliative care (PPC) and pediatric medical ethics (PME) overlap substantially, owing to a variety of historical, cultural, and social factors. This entwined relationship provides opportunities for leveraging the strong communication skills of both sets of providers, as well as the potential for resource sharing and research collaboration. At the same time, the personal and professional relationships between PPC and PME present challenges, including potential conflict with colleagues, perceived or actual bias toward a palliative care perspective in resolving ethical problems, potential delay or underuse of PME services, and a potential undervaluing of the medical expertise required for PPC consultation. We recommend that these challenges be managed by: (1) clearly defining and communicating clinical roles of PPC and PME staff, (2) developing questions that may prompt PPC and PME teams to request consultation from the other service, (3) developing explicit recusal criteria for PPC providers who also provide PME consultation, (4) ensuring that PPC and PME services remain organizationally distinct, and (5) developing well-defined and broad scopes of practice. Overall, the rich relationship between PPC and PME offers substantial opportunities to better serve patients and families facing difficult decisions.
2014-02
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2013-3608B" target="_blank" rel="noreferrer">10.1542/peds.2013-3608B</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
Adolescent
Backlog
Child
Communication
Ethics
Feudtner C
History
Humans
Infant
Journal Article
Medical
Nathanson PG
Palliative Care
Pediatrics
Resuscitation Orders
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/10.1542/peds.2013-3608D" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2013-3608D</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
Relational autonomy: moving beyond the limits of isolated individualism
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
adolescent; Child; Female; Humans; Male; Adolescent Psychology; Personal Autonomy; Physician-Patient Relations; Pediatrics; Parents; Withholding Treatment; Professional-Family Relations; Communication; Child Psychology; Palliative Care; Psychological; Models
Creator
An entity primarily responsible for making the resource
Walter JK; Ross LF
Description
An account of the resource
Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.
2014-02
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2013-3608D" target="_blank" rel="noreferrer">10.1542/peds.2013-3608D</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
Adolescent
Adolescent Psychology
Backlog
Child
Child Psychology
Communication
Female
Humans
Journal Article
Male
Models
Palliative Care
Parents
Pediatrics
Personal Autonomy
Physician-patient Relations
Professional-family Relations
Psychological
Ross LF
Walter JK
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/j.ccc.2012.12.002" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.ccc.2012.12.002</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
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Medical ethics in pediatric critical care
Publisher
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Critical Care Clinics
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
Subject
The topic of the resource
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
Creator
An entity primarily responsible for making the resource
Orioles A; Morrison WE
Description
An account of the resource
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
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.ccc.2012.12.002" target="_blank" rel="noreferrer">10.1016/j.ccc.2012.12.002</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
2013
Backlog
Child
Clinical
Critical Care
Critical Care Clinics
Decision Making
Dissent And Disputes
Ethics
Ethics Committees
Humans
Journal Article
Medical
Morrison WE
Orioles A
Parental Consent
Patient Rights
Pediatrics
Personal Autonomy
Professional-family Relations
Resource Allocation
Terminal Care
Tissue and Organ Procurement
Truth Disclosure
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/10.1136/medethics-2011-100104" target="_blank" rel="noreferrer">http://doi.org/10.1136/medethics-2011-100104</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
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Should religious beliefs be allowed to stonewall a secular approach to withdrawing and withholding treatment in children?
Publisher
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Journal Of Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
Subject
The topic of the resource
Child; Humans; retrospective studies; Intensive Care Units; Terminal Care; Medical Futility; Withholding Treatment; Professional-Family Relations; Culture; Conflict (Psychology); Religion and Psychology; Pediatric
Creator
An entity primarily responsible for making the resource
Brierley J; Linthicum J; Petros A
Description
An account of the resource
Religion is an important element of end-of-life care on the paediatric intensive care unit with religious belief providing support for many families and for some staff. However, religious claims used by families to challenge cessation of aggressive therapies considered futile and burdensome by a wide range of medical and lay people can cause considerable problems and be very difficult to resolve. While it is vital to support families in such difficult times, we are increasingly concerned that deeply held belief in religion can lead to children being potentially subjected to burdensome care in expectation of 'miraculous' intervention. We reviewed cases involving end-of-life decisions over a 3-year period. In 186 of 203 cases in which withdrawal or limitation of invasive therapy was recommended, agreement was achieved. However, in the 17 remaining cases extended discussions with medical teams and local support mechanisms did not lead to resolution. Of these cases, 11 (65%) involved explicit religious claims that intensive care should not be stopped due to expectation of divine intervention and complete cure together with conviction that overly pessimistic medical predictions were wrong. The distribution of the religions included Protestant, Muslim, Jewish and Roman Catholic groups. Five of the 11 cases were resolved after meeting religious community leaders; one child had intensive care withdrawn following a High Court order, and in the remaining five, all Christian, no resolution was possible due to expressed expectations that a 'miracle' would happen.
2013-09
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1136/medethics-2011-100104" target="_blank" rel="noreferrer">10.1136/medethics-2011-100104</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
2013
Backlog
Brierley J
Child
Conflict (Psychology)
Culture
Humans
Intensive Care Units
Journal Article
Journal of Medical Ethics
Linthicum J
Medical Futility
Pediatric
Petros A
Professional-family Relations
Religion and Psychology
Retrospective Studies
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/10.1136/medethics-2011-100428" target="_blank" rel="noreferrer">http://doi.org/10.1136/medethics-2011-100428</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
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The attitudes of neonatal professionals towards end-of-life decision-making for dying infants in Taiwan
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
2013
Subject
The topic of the resource
Cross-Sectional Studies; Female; Humans; infant; Male; Intensive Care Units; Terminal Care; decision making; referral and consultation; Adult; Attitude of Health Personnel; Education; Medical Staff; Withholding Treatment; Questionnaires; Middle Aged; Attitude to Death; Resuscitation Orders; Self Report; Neonatology; Medical; Neonatal; Nursing Staff; Newborn; Clinical; Ethics Committees; Taiwan; Hospital; continuing
Creator
An entity primarily responsible for making the resource
Huang L-C; Chen CH; Liu Hsin-Li; Lee Ho-Yu; Peng Niang-Huei; Wang Teh-Ming; Chang YC
Description
An account of the resource
The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of 'DNR' to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed.
2013-06
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1136/medethics-2011-100428" target="_blank" rel="noreferrer">10.1136/medethics-2011-100428</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
2013
Adult
Attitude Of Health Personnel
Attitude To Death
Backlog
Chang YC
Chen CH
Clinical
Continuing
Cross-sectional Studies
Decision Making
Education
Ethics Committees
Female
Hospital
Huang L-C
Humans
Infant
Intensive Care Units
Journal Article
Journal of Medical Ethics
Lee Ho-Yu
Liu Hsin-Li
Male
Medical
Medical Staff
Middle Aged
Neonatal
Neonatology
Newborn
Nursing Staff
Peng Niang-Huei
Questionnaires
Referral And Consultation
Resuscitation Orders
Self Report
Taiwan
Terminal Care
Wang Teh-Ming
Withholding Treatment
-
Dublin Core
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Title
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March 2018 List
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
March 2018 List
URL Address
<a href="http://doi.org/10.5546/aap.2016.298" target="_blank" rel="noreferrer">http://doi.org/10.5546/aap.2016.298</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
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Opinions of members of the National Civil (Family Proceedings) and Criminal Courts in withholding or withdrawing of life support situations in pediatrics
Publisher
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Archivos Argentinos De Pediatria
Date
A point or period of time associated with an event in the lifecycle of the resource
2016
Subject
The topic of the resource
Attitude to Death; Argentina; Child; Cross-Sectional Studies; decision-making; ethics; Health Care Surveys; Humans; legislation and jurisprudence; Life Support Care/ legislation & jurisprudence; Pediatric intensive care unit; Pediatrics/ legislation & jurisprudence; Withholding Treatment; Withholding Treatment/ legislation & jurisprudence
Creator
An entity primarily responsible for making the resource
Selandari JO; Ciruzzi MS; Roitman AJ; Ledesma F; Menendez C; Garcia HO
Description
An account of the resource
INTRODUCTION: The possibility of sustaining life functions makes it difficult to distinguish between a dying patient and a patient with chances of survival, raising a dilemma for everyone around them. On the one side, continuing with life support techniques that would only extend an irreversible process and result in physical and psychological damage and harm their dignity. On the other side, withholding or withdrawing life support without an adequate reflection and diagnostic-therapeutic effort which may lead to the death of a potentially recoverable child. In addition, making decisions in this context implies facing barriers that hinder the possibility of pursuing the patient's best interest. Among such barriers, the fear of litigation plays a major role. To what extent is this fear justified? OBJECTIVE: To explore the opinions of the members of the National Judiciary regarding the approach to withholding or withdrawing of life support from a legal stance. POPULATION AND METHODS: Professionals working in the criminal, civil and forensic medicine settings. Semistructured survey on three hypothetical case histories that implied making a decision to withhold or withdraw life support. RESULTS: One hundred and eighty-five surveys were distributed; 68 (36.76%) were partially completed and 51 (30.3%), in full. Twenty-eight (55%) survey respondents did not criminalize any of the three cases presented. Thirteen (25%) respondents considered that the decisions made in the three cases constituted a crime; 6 (12%), only in one case; and 4 (8%), in two out of the three. Crimes described by survey respondents included intentional homicide, wrongful death, and failure to render assistance. CONCLUSIONS: Forty-five percent of survey respondents considered that decisions made involved some form of crime.
2016-08
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.5546/aap.2016.298" target="_blank" rel="noreferrer">10.5546/aap.2016.298</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).
2016
Archivos Argentinos De Pediatria
Argentina
Attitude To Death
Child
Ciruzzi MS
Cross-sectional Studies
Decision-making
Ethics
Garcia HO
Health Care Surveys
Humans
Ledesma F
Legislation And Jurisprudence
Life Support Care/ legislation & jurisprudence
March 2018 List
Menendez C
Pediatric Intensive Care Unit
Pediatrics/ legislation & jurisprudence
Roitman AJ
Selandari JO
Withholding Treatment
Withholding Treatment/ legislation & jurisprudence
-
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.2014-1903" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2014-1903</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
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Talking with parents about end-of-life decisions for their children
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
2015
Subject
The topic of the resource
adolescent; Child; Female; Humans; infant; Male; Intensive Care Units; Palliative Care; Advance Directives; decision making; Pediatrics; Withholding Treatment; Prospective Studies; Professional-Family Relations; Communication; Life Support Care; Netherlands; Qualitative Research; Pediatric; adolescent; Preschool; decision making; infant; Newborn; DNAR; Professional-Family Relations; Pediatrics; Advance Directives; Communication
Creator
An entity primarily responsible for making the resource
de Vos MA; Bos AP; Plötz FB; van Heerde M; de Graaff Bert M; Tates K; Truog RD; Willems DL
Description
An account of the resource
BACKGROUND AND OBJECTIVE: Retrospective studies show that most parents prefer to share in decisions to forgo life-sustaining treatment (LST) from their children. We do not yet know how physicians and parents communicate about these decisions and to what extent parents share in the decision-making process. METHODS: We conducted a prospective exploratory study in 2 Dutch University Medical Centers. RESULTS: Overall, 27 physicians participated, along with 37 parents of 19 children for whom a decision to withhold or withdraw LST was being considered. Forty-seven conversations were audio recorded, ranging from 1 to 8 meetings per patient. By means of a coding instrument we quantitatively and qualitatively analyzed physicians' and parents' communicative behaviors. On average, physicians spoke 67% of the time, parents 30%, and nurses 3%. All physicians focused primarily on providing medical information, explaining their preferred course of action, and informing parents about the decision being reached by the team. Only in 2 cases were parents asked to share in the decision-making. Despite their intense emotions, most parents made great effort to actively participate in the conversation. They did this by asking for clarifications, offering their preferences, and reacting to the decision being proposed (mostly by expressing their assent). In the few cases where parents strongly preferred LST to be continued, the physicians either gave parents more time or revised the decision. CONCLUSIONS: We conclude that parents are able to handle a more active role than they are currently being given. Parents' greatest concern is that their child might suffer.
2015-02
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2014-1903" target="_blank" rel="noreferrer">10.1542/peds.2014-1903</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
2015
Adolescent
Advance Directives
Backlog
Bos AP
Child
Communication
de Graaff Bert M
de Vos MA
Decision Making
DNAR
Female
Humans
Infant
Intensive Care Units
Journal Article
Life Support Care
Male
Netherlands
Newborn
Palliative Care
Pediatric
Pediatrics
Plötz FB
Preschool
Professional-family Relations
Prospective Studies
Qualitative Research
Tates K
Truog RD
van Heerde M
Willems DL
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/10.1542/peds.2010-0420" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2010-0420</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
Alterations in end-of-life support in the pediatric intensive care unit.
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
2010
Subject
The topic of the resource
Child; Humans; Advance Directives; Withholding Treatment; Life Support Care; Resuscitation Orders; Brain Death; Pediatric; DNAR; Intensive Care Units; Terminal Care
Creator
An entity primarily responsible for making the resource
Lee KJ; Tieves K; Scanlon MC
Description
An account of the resource
OBJECTIVE: Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs., METHODS: This was a retrospective, descriptive study. Variables collected included end-of-life support category, race, length of stay, operative status, reason for admission, and Pediatric Index of Mortality 2 score, as well as the number of ICU beds and the presence of trainees., RESULTS: There were 1745 deaths at 35 institutions between January 1, 2004, and September 30, 2005. Of those, 1263 had complete data and were analyzed. The end-of-life support category distribution was as follows: brain death, 296 (23%); do not resuscitate, 205 (16%); limitation of support, 36 (3%); withdrawal of support, 579 (46%); no limitation, 124 (10%); no advance directives, 23 (2%). For further analyses, end-of-life support categories were grouped as limitation (ie, do not resuscitate, limitation of support, or withdrawal of support) versus no limitation (ie, no limitation or no advance directive). Brain death was not included in further analyses. The majority of deaths were in the limitation group (n=820 [85%]), and 12 (40%) of 30 institutions had 100% of deaths in this group. There were significant differences between institutions (P<.001). Decisions for limitation were seen less frequently in the black race (112 [76%] of 147 deaths; P=.037) and in institutions with no trainees (56 [69%] of 81 deaths; P<.001)., CONCLUSIONS: Decisions to limit support are common. Black race and an absence of trainees are associated with decreased frequency of limitation decisions.
2010
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2010-0420" target="_blank" rel="noreferrer">10.1542/peds.2010-0420</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
2010
Advance Directives
Backlog
Brain Death
Child
DNAR
Humans
Intensive Care Units
Journal Article
Lee KJ
Life Support Care
Pediatric
Pediatrics
Resuscitation Orders
Scanlon MC
Terminal Care
Tieves K
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/10.1097/01.pcc.0000170616.28175.d9" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.pcc.0000170616.28175.d9</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
What influences parents' decisions to limit or withdraw life support?
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
2005
Subject
The topic of the resource
Child; Female; Humans; Male; Adult; Withholding Treatment; Emotions; Prospective Studies; Middle Aged; Attitude to Death; Pilot Projects; Life Change Events; adolescent; Preschool; decision making; infant; ICU Decision Making; Parents/psychology; Life Support Care/psychology
Creator
An entity primarily responsible for making the resource
Sharman M; Meert KL; Sarnaik AP
Description
An account of the resource
OBJECTIVE: Decisions to forgo life support from critically ill children are commonly faced by parents and physicians. Previous research regarding parents' perspectives on the decision-making process has been limited by retrospective methods and the use of closed-ended questionnaires. We prospectively identified and described parents' self-reported influences on decisions to forgo life support from their children. Deeper understanding of parents' views will allow physicians to focus end-of-life discussions on factors important to parents and help resolve conflicts. DESIGN: Prospective, qualitative pilot study. SETTING: Pediatric intensive care unit of a university-affiliated children's hospital. PARTICIPANTS: A total of 14 parents of ten children whose pediatric intensive care unit physician had made a recommendation to limit or withdraw life support. INTERVENTIONS:: In-depth, semistructured interviews were conducted with parents during their decision-making process. MEASUREMENTS AND MAIN RESULTS: Factors influencing the parents in this study in their decision to forgo life support included their previous experience with death and end-of-life decision making for others, their personal observations of their child's suffering, their perceptions of their child's will to survive, their need to protect and advocate for their child, and the family's financial resources and concerns regarding life-long care. Parents in this study expressed the desire to do what is best for their child but struggled with feelings of selfishness, guilt, and the need to avoid agony and sorrow. Physician recommendations, review of options, and joint formulation of a plan helped parents gain a sense of control over their situation. Parents of eight children agreed to forgo life support and parents of two did not. CONCLUSIONS: Prospective interviews with open-ended questions identified factors influencing parents' decision making not previously described in the critical care literature such as parents' past experiences with end-of-life decisions and their anticipated emotional adjustments and future resources. Inclusion of these factors into discussions is important to parents and may facilitate decisions regarding the limitation or withdrawal of life support.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.pcc.0000170616.28175.d9" target="_blank" rel="noreferrer">10.1097/01.pcc.0000170616.28175.d9</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
2005
Adolescent
Adult
Attitude To Death
Backlog
Child
Decision Making
Emotions
Female
Humans
ICU Decision Making
Infant
Journal Article
Life Change Events
Life Support Care/psychology
Male
Meert KL
Middle Aged
Parents/psychology
Pediatric Critical Care Medicine
Pilot Projects
Preschool
Prospective Studies
Sarnaik AP
Sharman M
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/10.1542/peds.2004-0905" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2004-0905</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
New and lingering controversies in pediatric end-of-life care
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
2005
Subject
The topic of the resource
Child; Humans; Analgesics; Data Collection; Attitude of Health Personnel; Medical Futility; Medical Staff; Withholding Treatment; Life Support Care; Medical; Practice Guidelines; ICU Decision Making; Pain/drug therapy; Opioid/therapeutic use; Specialties; Terminal Care/psychology; Nurses/psychology; Hospital/psychology
Creator
An entity primarily responsible for making the resource
Solomon MZ; Sellers DE; Heller KS; Dokken DL; Levetown M; Rushton C; Truog RD; Fleischman AR
Description
An account of the resource
OBJECTIVES: Professional societies, ethics institutes, and the courts have recommended principles to guide the care of children with life-threatening conditions; however, little is known about the degree to which pediatric care providers are aware of or in agreement with these guidelines. The study's objectives were to determine the extent to which physicians and nurses in critical care, hematology/oncology, and other subspecialties are in agreement with one another and with widely published ethical recommendations regarding the withholding and withdrawing of life support, the provision of adequate analgesia, and the role of parents in end-of-life decision-making. METHODS: Three children's hospitals and 4 general hospitals with PICUs in eastern, southwestern, and southern parts of the United States were surveyed. This population-based sample was composed of attending physicians, house officers, and nurses who cared for children (age: 1 month to 18 years) with life-threatening conditions in PICUs or in medical, surgical, or hematology/oncology units, floors, or departments. Main outcome measures included concerns of conscience, knowledge and beliefs, awareness of published guidelines, and agreement or disagreement with guidelines. RESULTS: A total of 781 clinicians were sampled, including 209 attending physicians, 116 house officers, and 456 nurses. The overall response rate was 64%. Fifty-four percent of house officers and substantial proportions of attending physicians and nurses reported, "At times, I have acted against my conscience in providing treatment to children in my care." For example, 38% of critical care attending physicians and 25% of hematology/oncology attending physicians expressed these concerns, whereas 48% of critical care nurses and 38% of hematology/oncology nurses did so. Across specialties, approximately 20 times as many nurses, 15 times as many house officers, and 10 times as many attending physicians agreed with the statement, "Sometimes I feel we are saving children who should not be saved," as agreed with the statement, "Sometimes I feel we give up on children too soon." However, hematology/oncology attending physicians (31%) were less likely than critical care (56%) and other subspecialty (66%) attending physicians to report, "Sometimes I feel the treatments I offer children are overly burdensome." Many respondents held views that diverged widely from published recommendations. Despite a lack of awareness of key guidelines, across subspecialties the vast majority of attending physicians (range: 92-98%, depending on specialty) and nurses (range: 83-85%) rated themselves as somewhat to very knowledgeable regarding ethical issues. CONCLUSIONS: There is a need for more hospital-based ethics education and more interdisciplinary and cross-subspecialty discussion of inherently complex and stressful pediatric end-of-life cases. Education should focus on establishing appropriate goals of care, as well as on pain management, medically supplied nutrition and hydration, and the appropriate use of paralytic agents. More research is needed on clinicians' regard for the dead-donor rule.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2004-0905" target="_blank" rel="noreferrer">10.1542/peds.2004-0905</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
2005
Analgesics
Attitude Of Health Personnel
Backlog
Child
Data Collection
Dokken DL
Fleischman AR
Heller KS
Hospital/psychology
Humans
ICU Decision Making
Journal Article
Levetown M
Life Support Care
Medical
Medical Futility
Medical Staff
Nurses/psychology
Opioid/therapeutic use
Pain/drug Therapy
Pediatrics
Practice Guidelines
Rushton C
Sellers DE
Solomon MZ
Specialties
Terminal Care/psychology
Truog RD
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/10.1007/bf03018408" target="_blank" rel="noreferrer">http://doi.org/10.1007/bf03018408</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
Simple changes can improve conduct of end-of-life care in the intensive care unit.
Publisher
An entity responsible for making the resource available
Canadian Journal Of Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Female; Humans; Male; Attitude of Health Personnel; Aged; Middle Aged; Resuscitation Orders; Intervention Studies; Patient Admission; Pastoral Care; retrospective studies; cause of death; DNAR; cardiopulmonary resuscitation; Intensive Care Units; Life Support Care; Palliative Care; Withholding Treatment; Analgesics/tu [Therapeutic Use]; Diazepam/tu [Therapeutic Use]; DNAR Outcomes; Hypnotics and Sedatives/tu [Therapeutic Use]; Nurses/px [Psychology]; Physicians/px [Psychology]
Creator
An entity primarily responsible for making the resource
Hall RI; Rocker GM; Murray D
Description
An account of the resource
PURPOSE: To describe changes to the conduct of withdrawal of life support (WOLS) in two teaching hospital tertiary care medical surgical intensive care units (ICUs) in a single centre over two distinct time periods., METHODS: We used a retrospective chart review with a before and after comparison. We assessed aspects of end-of-life care for ICU patients dying after a WOLS before and after we introduced instruments to clarify do not resuscitate (DNR) orders and to standardize the WOLS process, sought family input into the conduct of end-of-life care, and modified physicians' orders regarding use of analgesia and sedation., RESULTS: One hundred thirty-eight patients died following life support withdrawal in the ICUs between July 1996 and June 1997 (PRE) and 168 patients died after a WOLS between May 1998 and April 1999 (POST). Time from ICU admission to WOLS (mean +/- SD) was shorter in the POST period (191 +/- 260 hr PRE vs 135 +/- 205 hr POST, P = 0.05). Fewer patients in the POST group received cardiopulmonary resuscitation in the 12-hr interval prior to death (PRE = 7; POST = 0: P < 0.05). Fewer comfort medications were used (PRE: 1.7 +/- 1.0 vs POST: 1.4 +/- 1.0; P < 0.05). Median cumulative dose of diazepam (PRE: 20.0 vs POST: 10.0 mg; P < 0.05) decreased. Documented involvement of physicians in WOLS discussions was unchanged but increased for pastoral care (PRE: 10/138 vs POST: 120/168 cases; P < 0.05). The majority of nurses (80%) felt that the DNR and WOLS checklists led to improved process around WOLS., CONCLUSION: Simple changes to the process of WOLS can improve conduct of end-of-life care in the ICU.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1007/bf03018408" target="_blank" rel="noreferrer">10.1007/bf03018408</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
2004
Aged
Analgesics/tu [Therapeutic Use]
Attitude Of Health Personnel
Backlog
Canadian Journal Of Anaesthesia
Cardiopulmonary Resuscitation
Cause Of Death
Diazepam/tu [Therapeutic Use]
DNAR
DNAR Outcomes
Female
Hall RI
Humans
Hypnotics and Sedatives/tu [Therapeutic Use]
Intensive Care Units
Intervention Studies
Journal Article
Life Support Care
Male
Middle Aged
Murray D
Nurses/px [Psychology]
Palliative Care
Pastoral Care
Patient Admission
Physicians/px [Psychology]
Resuscitation Orders
Retrospective Studies
Rocker GM
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/10.1097/00003246-200201000-00032" target="_blank" rel="noreferrer">http://doi.org/10.1097/00003246-200201000-00032</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
Parental perspectives on end-of-life care in the 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
2002
Subject
The topic of the resource
Child; Female; Humans; Male; Intensive Care Units; Terminal Care; Adult; Withholding Treatment; Prognosis; Questionnaires; Boston; Pain; Quality of Health Care; quality of life; Pediatric; Empirical Approach; Death and Euthanasia; decision making; ICU Decision Making; Parents/psychology
Creator
An entity primarily responsible for making the resource
Meyer EC; Burns JP; Griffith JL; Truog RD
Description
An account of the resource
OBJECTIVE: To identify priorities for quality end-of-life care from the parents' perspective. DESIGN: Anonymous, self-administered questionnaire. SETTING: Three pediatric intensive care units in Boston. PARTICIPANTS: Parents of children who had died after withdrawal of life support. MEASUREMENT AND MAIN RESULTS: Parents' views of the adequacy of pain management, decision making, and social support during and after the death of their child were measured with the Parental Perspectives Questionnaire. Of 96 eligible households, 56 (58%) responded. In 90% of cases, physicians initiated discussion of withdrawal of life support, although nearly half of parents had considered it independently. Among decision-making factors, parents rated the quality of life, likelihood of improvement, and perception of their child's pain as most important. Twenty percent of parents disagreed that their children were comfortable in their final days. Fifty-five percent of parents felt that they had little to no control during their child's final days, and nearly a quarter reported that, if able, they would have made decisions differently. There were significant differences (p < .001) between the involvement of family, friends, and staff members at the time of death and greater agreement (p < .01) about the decision to withdraw support between parents and staff members than with other family members. CONCLUSIONS: Parents place the highest priorities on quality of life, likelihood of improvement, and perception of their child's pain when considering withdrawal of life support. Parents make such decisions and garner psychosocial support in the context of a social network that changes over time and includes healthcare professionals, family, and friends.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00003246-200201000-00032" target="_blank" rel="noreferrer">10.1097/00003246-200201000-00032</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
2002
Adult
Backlog
Boston
Burns JP
Child
Critical Care Medicine
Death and Euthanasia
Decision Making
Empirical Approach
Female
Griffith JL
Humans
ICU Decision Making
Intensive Care Units
Journal Article
Male
Meyer EC
Pain
Parents/psychology
Pediatric
Prognosis
Quality Of Health Care
Quality Of Life
Questionnaires
Terminal Care
Truog RD
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/10.1542/peds.112.5.e371" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.112.5.e371</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
Circumstances surrounding end of life in a pediatric intensive care unit
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
2003
Subject
The topic of the resource
Child; Female; Humans; infant; Male; Intensive Care Units; Adult; Parent-Child Relations; Withholding Treatment; Attitude to Death; Resuscitation Orders; Ontario; Analgesia; Treatment Failure; Pediatric; adolescent; Preschool; patient care team; decision making; infant; Newborn; ICU Decision Making; cause of death; Parents/psychology; Physicians/psychology; Terminal Care/psychology
Creator
An entity primarily responsible for making the resource
Garros D; Rosychuk RJ; Cox PN
Description
An account of the resource
OBJECTIVE: Approximately 60% of deaths in pediatric intensive care units follow limitation or withdrawal of life-sustaining treatment (LST). We aimed to describe the circumstances surrounding decision making and end-of-life care in this setting. METHODS: We conducted a prospective, descriptive study based on a survey with the intensivist after every consecutive death during an 8-month period in a single multidisciplinary pediatric intensive care unit. Summary statistics are presented as percentage, mean +/- standard deviation, or median and range; data are compared using the Mantel-Haenszel test and shown as survival curves. RESULTS: Of the 99 observed deaths, 27 involved failed cardiopulmonary resuscitation; of the remaining 72, 39 followed withdrawal/limitation (W/LT) of LST, 20 were do not resuscitate (DNR), and 13 were brain deaths (BDs). Families initiated discussions about forgoing LST in 24% (17 of 72) of cases. Consensus between caregivers and staff about forgoing LST as the best approach was reached after the first meeting with 51% (35 of 68) of families; 46% (31 of 68) required >or=2 meetings (4 not reported). In the DNR group, the median time to death after consensus was 24 hours and for W/LT was 3 hours. LST was later withdrawn in 11 of 20 DNR cases. The family was present in 76% (45 of 59) of cases when LST was forgone. The dying patient was held by the family in 78% (35 of 45) of these occasions. CONCLUSIONS: More than 1 formal meeting was required to reach consensus with families about forgoing LST in almost half of the patients. Families often held their child at the time of death. The majority of children died quickly after the end-of-life decision was made.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.112.5.e371" target="_blank" rel="noreferrer">10.1542/peds.112.5.e371</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
2003
Adolescent
Adult
Analgesia
Attitude To Death
Backlog
Cause Of Death
Child
Cox PN
Decision Making
Female
Garros D
Humans
ICU Decision Making
Infant
Intensive Care Units
Journal Article
Male
Newborn
Ontario
Parent-child Relations
Parents/psychology
Patient Care Team
Pediatric
Pediatrics
Physicians/psychology
Preschool
Resuscitation Orders
Rosychuk RJ
Terminal Care/psychology
Treatment Failure
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/10.1542/peds.2003-0654-f" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2003-0654-f</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
Circumstances surrounding the deaths of hospitalized children: opportunities for pediatric palliative care.
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
2004
Subject
The topic of the resource
Child; Female; Hospitalization; Humans; infant; Male; Palliative Care; Terminal Care; Terminally Ill; Withholding Treatment; Hospital Mortality; Length of Stay; Longitudinal Studies; Academic Medical Centers; adolescent; Preschool; Non-U.S. Gov't; Research Support; infant; Newborn; retrospective studies; Hospitalized; Pain/diagnosis/drug therapy
Creator
An entity primarily responsible for making the resource
Carter BS; Howenstein M; Gilmer MJ; et al
Description
An account of the resource
OBJECTIVES: Little is known regarding the assessment and treatment of symptoms during end-of-life (EOL) care for children. This study was conducted to describe the circumstances surrounding the deaths of hospitalized terminally ill children, especially pain and symptom management by the multidisciplinary pediatric care team. DESIGN: Patients in the neonatal intensive care unit, pediatric critical care unit, or general pediatric units of Vanderbilt Children's Hospital who were hospitalized at the time of death, between July 1, 2000, and June 30, 2001, were identified. Children eligible for the survey had received inpatient EOL care at the hospital for at least 24 hours before death. A retrospective medical record review was completed to describe documentation of care for these children and their families during the last 72 hours of life. RESULTS: Records of children who had received inpatient EOL care were identified (n = 105). A majority (87%) of children were in an intensive care setting at the time of death. Most deaths occurred in the pediatric critical care unit (56%), followed by the neonatal intensive care unit (31%). Pain medication was received by 90% of the children in the last 72 hours of life, and 55% received additional comfort care measures. The presence of symptoms other than pain was infrequently documented. CONCLUSIONS: The duration of hospitalization for most children dying in this inpatient setting was sufficient for provision of interdisciplinary pediatric palliative care. Management of pain and other symptoms was accomplished for many children. The documentation of pain and symptom assessment and management can be improved but requires new tools.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2003-0654-f" target="_blank" rel="noreferrer">10.1542/peds.2003-0654-f</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
2004
Academic Medical Centers
Adolescent
Backlog
Carter BS
Child
et al
Female
Gilmer MJ
Hospital Mortality
Hospitalization
Hospitalized
Howenstein M
Humans
Infant
Journal Article
Length Of Stay
Longitudinal Studies
Male
Newborn
Non-U.S. Gov't
Pain/diagnosis/drug therapy
Palliative Care
Pediatrics
Preschool
Research Support
Retrospective Studies
Terminal Care
Terminally Ill
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/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/10.1097/00006254-197804000-00013" target="_blank" rel="noreferrer">http://doi.org/10.1097/00006254-197804000-00013</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
Pediatricians' attitudes affecting decision-making in defective newborns
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
1977
Subject
The topic of the resource
Female; Humans; infant; Male; Parental Consent; Adult; Attitude of Health Personnel; Withholding Treatment; Questionnaires; Middle Aged; Age Factors; Sex Factors; Religion; Ethics; Medical; Empirical Approach; decision making; Newborn; ICU Decision Making; Pediatrics/standards; Abnormalities/therapy
Creator
An entity primarily responsible for making the resource
Todres ID; Krane D; Howell MC; Shannon DC
Description
An account of the resource
A questionnaire designed to identify the factors that influence the resolution of ethical dilemmas was returned by 230 (57% of the total) Massachusetts pediatricians. The decision to recommend surgery for an infant with Down's syndrome with duodenal atresia when the parents had refused surgery was influenced by religious affiliation (P less than .01), religious activity (P less than .04), and sex (P=.05). Of those favoring surgery, 40.2% would pursue a court order. The decision to recommend surgery for an infant with severe meningomyelocele when the parents' position was not stated was influenced by age (P less than .01), religious activity (P less than .02), and specialization (P less than .008). When the parents' wishes were expressed, the majority of the pediatricians modified their decision in accord with these wishes. In response to general ethical questions, 79.6% of all pediatricians thought that parents should have the right to withold consent for surgery. Equal numbers thought that psychosocial reasons justified witholding lifesaving procedures. Among a variety of factors, they thought that willingness of the parents to care for the child would influence the decision to take heroic measures. There were 90.4% who thought that ethics should be part of medical education; 55.7% indicated this need throughout their careers.
1977
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00006254-197804000-00013" target="_blank" rel="noreferrer">10.1097/00006254-197804000-00013</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
1977
Abnormalities/therapy
Adult
Age Factors
Attitude Of Health Personnel
Backlog
Decision Making
Empirical Approach
Ethics
Female
Howell MC
Humans
ICU Decision Making
Infant
Journal Article
Krane D
Male
Medical
Middle Aged
Newborn
Parental Consent
Pediatrics
Pediatrics/standards
Questionnaires
Religion
Sex Factors
Shannon DC
Todres ID
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/10.2307/3560572" 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/10.1001/archinte.1995.00430060097012" target="_blank" rel="noreferrer">http://doi.org/10.1001/archinte.1995.00430060097012</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
Decisions about life-sustaining treatment. Impact of physicians' behaviors on the family
Publisher
An entity responsible for making the resource available
Archives Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
Subject
The topic of the resource
Humans; Consensus; Withholding Treatment; Communication; Life Support Care; Physician's Role; Nurse's Role; Professional-Patient Relations; Disclosure; Empirical Approach; P.H.S.; Professional Patient Relationship; Research Support; U.S. Gov't; Death and Euthanasia; Interviews; decision making; Family/psychology; Practice Guidelines
Creator
An entity primarily responsible for making the resource
Tilden VP; Tolle SW; Garland MJ; Nelson CA
Description
An account of the resource
BACKGROUND: Despite the growing availability of advance directives, most patients in the intensive care unit lack written directives, and, therefore, consultation with families about treatment decisions remains the rule. In the context of decision making about withdrawing life-sustaining treatments, we investigated which physician and nurse behaviors families find supportive and which behaviors increase the family's burden. METHODS: We conducted intensive 1- to 2-hour-long individual interviews using a semistructured interview protocol with 32 family members of patients without advance directives whose deaths followed a stay in the intensive care unit and withdrawal of treatment. We analyzed more than 700 pages of verbatim interview data using content analysis techniques and achieved more than 90% interrater agreement on data codes. RESULTS: Themes emerged as families identified selected physician and nursing behaviors as helpful: encouraging advanced planning, timely communication, clarification of families' roles, facilitating family consensus, and accommodating family's grief. Behaviors that made families feel excluded or increased their burden included postponing discussions about treatment withdrawal, delaying withdrawal once scheduled, placing the full burden of decision making on one person, withdrawing from the family, and defining death as a failure. CONCLUSIONS: Study findings provide an increased understanding of the unmet needs of families and serve to guide physicians and nurses in reducing actions that increase families' burdens as they participate in treatment withdrawal decisions.
1995
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/archinte.1995.00430060097012" target="_blank" rel="noreferrer">10.1001/archinte.1995.00430060097012</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
1995
Archives Of Internal Medicine
Backlog
Communication
Consensus
Death and Euthanasia
Decision Making
Disclosure
Empirical Approach
Family/psychology
Garland MJ
Humans
Interviews
Journal Article
Life Support Care
Nelson CA
Nurse's Role
P.H.S.
Physician's Role
Practice Guidelines
Professional Patient Relationship
Professional-patient Relations
Research Support
Tilden VP
Tolle SW
U.S. Gov't
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/10.1001/archpedi.1994.02170010089021" target="_blank" rel="noreferrer">http://doi.org/10.1001/archpedi.1994.02170010089021</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
Termination of nutrition and hydration in a child with vegetative state
Publisher
An entity responsible for making the resource available
Archives Of Pediatrics & Adolescent Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
Subject
The topic of the resource
Female; Humans; Parents; Withholding Treatment; Euthanasia; Dissent and Disputes; Group Processes; Enteral Nutrition; Death and Euthanasia; decision making; infant; Brain Diseases; Child Abuse Amendments 1984; Clinical; Coma/etiology/therapy; Connecticut; Ethics Committees; Federal Government; Government Agencies; Government Regulation; Hartford Hospital (CT); Passive/legislation & jurisprudence; Right to Die/legislation & jurisprudence; Status Epilepticus/complications
Creator
An entity primarily responsible for making the resource
Leicher CR; DiMario FJ
Description
An account of the resource
A child in a vegetative state may present difficult decisions for physicians and families regarding the course of treatment. We report a case of a child who entered a prolonged vegetative state following status epilepticus. The child's parents requested termination of artificial means of nutrition and hydration. That request culminated in a complex legal intervention by multiple state agencies and attracted local media attention. This article presents the details of the case and discusses the medical and legal complexities encountered. The diagnosis and prognosis of the persistent vegetative state in children have recently been defined. Decision making in these circumstances should be based on adequate, careful clinical evaluation of the medical facts. Hospital ethics committees can provide an independent forum in which the diverse viewpoints in a case may be examined. Decision making should optimally be accomplished between families and caretakers.
1994
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/archpedi.1994.02170010089021" target="_blank" rel="noreferrer">10.1001/archpedi.1994.02170010089021</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
1994
Archives Of Pediatrics & Adolescent Medicine
Backlog
Brain Diseases
Child Abuse Amendments 1984
Clinical
Coma/etiology/therapy
Connecticut
Death and Euthanasia
Decision Making
DiMario FJ
Dissent And Disputes
Enteral Nutrition
Ethics Committees
Euthanasia
Federal Government
Female
Government Agencies
Government Regulation
Group Processes
Hartford Hospital (CT)
Humans
Infant
Journal Article
Leicher CR
Parents
Passive/legislation & jurisprudence
Right to Die/legislation & jurisprudence
Status Epilepticus/complications
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/10.1001/jama.1994.03520160047041" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.1994.03520160047041</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
Comfort care for terminally ill patients. The appropriate use of nutrition and hydration
Publisher
An entity responsible for making the resource available
Jama
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
Subject
The topic of the resource
Female; Humans; Male; Withholding Treatment; Prospective Studies; Aged; Middle Aged; New York; Risk Assessment; Fluid Therapy; Parenteral Nutrition; quality of life; 80 and over; Empirical Approach; Death and Euthanasia; Hunger; Nursing Homes/standards; Nutrition; NY); Palliative Care/psychology; Psychological; St. John's Home (Rochester; Stress; Terminal Care/methods/psychology/standards; Thirst; Xerostomia/therapy
Creator
An entity primarily responsible for making the resource
McCann RM; Hall WJ; Groth-Juncker A
Description
An account of the resource
OBJECTIVE--To determine the frequency of symptoms of hunger and thirst in a group of terminally ill patients and determine whether these symptoms could be palliated without forced feeding, forced hydration, or parenteral alimentation. DESIGN--Prospective evaluation of consecutively admitted terminally ill patients treated in a comfort care unit. SETTING--Ten-bed comfort care unit in a 471-bed long-term care facility. PARTICIPANTS--Mentally aware, competent patients with terminal illnesses monitored from time of admission to time of death while residing in the comfort care unit. MAIN OUTCOME MEASURES--Symptoms of hunger, thirst, and dry mouth were recorded, and the amounts and types of food and fluids necessary to relieve these symptoms were documented. The subjective level of comfort was assessed longitudinally in all patients. RESULTS--Of the 32 patients monitored during the 12 months of study, 20 patients (63%) never experienced any hunger, while 11 patients (34%) had symptoms only initially. Similarly, 20 patients (62%) experienced either no thirst or thirst only initially during their terminal illness. In all patients, symptoms of hunger, thirst, and dry mouth could be alleviated, usually with small amounts of food, fluids, and/or by the application of ice chips and lubrication to the lips. Comfort care included use of narcotics for relief of pain or shortness of breath in 94% of patients. CONCLUSIONS--In this series, patients terminally ill with cancer generally did not experience hunger and those who did needed only small amounts of food for alleviation. Complaints of thirst and dry mouth were relieved with mouth care and sips of liquids far less than that needed to prevent dehydration. Food and fluid administration beyond the specific requests of patients may play a minimal role in providing comfort to terminally ill patients.
1994
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/jama.1994.03520160047041" target="_blank" rel="noreferrer">10.1001/jama.1994.03520160047041</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
1994
80 And Over
Aged
Backlog
Death and Euthanasia
Empirical Approach
Female
Fluid Therapy
Groth-Juncker A
Hall WJ
Humans
Hunger
JAMA
Journal Article
Male
McCann RM
Middle Aged
New York
Nursing Homes/standards
Nutrition
NY)
Palliative Care/psychology
Parenteral Nutrition
Prospective Studies
Psychological
Quality Of Life
Risk Assessment
St. John's Home (Rochester
Stress
Terminal Care/methods/psychology/standards
Thirst
Withholding Treatment
Xerostomia/therapy
-
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/10.1001/jama.272.16.1271" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.272.16.1271</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
Limitations and withdrawals of medical intervention in pediatric critical care
Publisher
An entity responsible for making the resource available
Jama
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
Subject
The topic of the resource
Child; Female; Humans; Male; Survival Rate; United States; Intensive Care Units; Withholding Treatment; Hospital Mortality; Resuscitation Orders; Patient Selection; Analysis of Variance; Outcome and Process Assessment (Health Care); Preschool; Empirical Approach; Death and Euthanasia; infant; ICU Decision Making; Intervention; Interventions; Life Support Care/utilization; Pediatric/standards/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Levetown M; Pollack MM; Cuerdon TT; Ruttimann UE; Glover JJ
Description
An account of the resource
OBJECTIVE--To investigate the use and implementation in pediatric intensive care units (PICUs) of three levels of restriction of medical intervention: do not resuscitate (DNR), additional limitations of medical interventions beyond DNR, and withdrawal of care. DESIGN--Consecutive patients admitted between December 1989 and January 1992. SETTING--A total of 16 PICUs randomly selected to represent variability in size, teaching status, and presence or absence of a pediatric intensivist and unit coordination. MAIN OUTCOME MEASURES--Profiles of children undergoing restrictions of medical interventions including the influence of chronic disease, the justifications for restrictions, and description of implementation practices. PATIENTS--All pediatric admissions undergoing restrictions (n = 119) drawn from 5415 consecutive PICU admissions. RESULTS--A total of 94 (79%) of the restriction patients died during the PICU course, representing 38% of all deaths. A total of 73 restrictions (61%) resulted from acute disease, most involving the central nervous system or respiratory system. Restrictions were evenly divided between DNR (39%), additional limitations of medical intervention beyond DNR (27%), and withdrawals of medical intervention (34%). Survival decreased with increasing levels of restriction from 35% of DNR patients to 9% of patients with additional limitations and 2% of withdrawal patients. Imminent death was cited as the justification for restrictions in 70% of cases, no relational potential was cited in 22%, and excessive burden was cited in 8%. CONCLUSIONS--Restrictions of medical intervention were used in all PICUs surveyed. Although severe chronic disease was common among restriction patients, acute disease was the predominant event precipitating placement of restrictions. Imminent death, not quality of life or excessive burden, was the most common justification.
1994
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/jama.272.16.1271" target="_blank" rel="noreferrer">10.1001/jama.272.16.1271</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
1994
Analysis of Variance
Backlog
Child
Cuerdon TT
Death and Euthanasia
Empirical Approach
Female
Glover JJ
Hospital Mortality
Humans
ICU Decision Making
Infant
Intensive Care Units
Intervention
Interventions
JAMA
Journal Article
Levetown M
Life Support Care/utilization
Male
Outcome And Process Assessment (health Care)
Patient Selection
Pediatric/standards/statistics & numerical data
Pollack MM
Preschool
Resuscitation Orders
Ruttimann UE
Survival Rate
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/s0031-3955(16)38879-4" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0031-3955(16)38879-4</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
Ethical issues in the pediatric intensive care unit
Publisher
An entity responsible for making the resource available
Pediatric Clinics Of North America
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
Subject
The topic of the resource
Child; Humans; United States; Parental Consent; Pediatrics; Withholding Treatment; Social Values; Intensive Care; Minors; Tissue and Organ Procurement; Ethics; Uncertainty; Medical; adolescent; Preschool; Professional Patient Relationship; infant; ICU Decision Making; Critical Illness/psychology; Judicial Role; Value of Life
Creator
An entity primarily responsible for making the resource
Frader JE; Thompson A
Description
An account of the resource
Advanced technology and better scientific understanding of mechanisms of disease now permit intensive care personnel to extend life beyond what some patients and families consider reasonable, leading, in part, to the "patients' rights" movement and the articulation of legal and moral guidelines for foregoing life support. In the case of pediatrics, commentaries on a few of the topics that have arisen most frequently or have provided the greatest challenge in the authors' experience are provided.
1994
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0031-3955(16)38879-4" target="_blank" rel="noreferrer">10.1016/s0031-3955(16)38879-4</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
1994
Adolescent
Backlog
Child
Critical Illness/psychology
Ethics
Frader JE
Humans
ICU Decision Making
Infant
Intensive Care
Journal Article
Judicial Role
Medical
Minors
Parental Consent
Pediatric Clinics of North America
Pediatrics
Preschool
Professional Patient Relationship
Social Values
Thompson A
Tissue and Organ Procurement
Uncertainty
United States
Value of Life
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/10.1046/j.1460-9592.2001.00701.x" target="_blank" rel="noreferrer">http://doi.org/10.1046/j.1460-9592.2001.00701.x</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
Review of ethics in paediatric anaesthesia: intensive care issues
Publisher
An entity responsible for making the resource available
Paediatric Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Child; Humans; Intensive Care Units; Withholding Treatment; Ethics; Third-Party Consent; Clinical; ICU Decision Making; Anesthesiology/legislation & jurisprudence; Brain Death/diagnosis; Pediatric/legislation & jurisprudence; Tissue Donors/legislation & jurisprudence
Creator
An entity primarily responsible for making the resource
Edgar J; Morton NS; Pace NA
Description
An account of the resource
This is the third of a series of three articles examining the recent changes in the law in relation to ethics and the practice of paediatric anaesthesia. The review covers, in a practical question and answer format, the topics of consent, research, intensive care issues and organ donation in children.
2001
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1046/j.1460-9592.2001.00701.x" target="_blank" rel="noreferrer">10.1046/j.1460-9592.2001.00701.x</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
Anesthesiology/legislation & jurisprudence
Backlog
Brain Death/diagnosis
Child
Clinical
Edgar J
Ethics
Humans
ICU Decision Making
Intensive Care Units
Journal Article
Morton NS
Pace NA
Paediatric Anaesthesia
Pediatric/legislation & jurisprudence
Third-Party Consent
Tissue Donors/legislation & jurisprudence
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/10.1056/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/10.1097/00043426-200111000-00004" target="_blank" rel="noreferrer">http://doi.org/10.1097/00043426-200111000-00004</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
Variables influencing end-of-life care in children and adolescents with cancer
Publisher
An entity responsible for making the resource available
Journal Of Pediatric Hematology/oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Child; Female; Humans; Male; Adult; Withholding Treatment; Resuscitation Orders; adolescent; Preschool; Empirical Approach; Death and Euthanasia; decision making; infant; cause of death; Neoplasms/complications/therapy; location of death; hospice care; home care services; Terminal Care/trends
Creator
An entity primarily responsible for making the resource
Klopfenstein KJ; Hutchison C; Clark C; Young D; Ruymann FB
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/00043426-200111000-00004" target="_blank" rel="noreferrer">10.1097/00043426-200111000-00004</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
BACKGROUND: The purpose of this study was to describe the variables influencing end-of-life care in children and adolescents dying of cancer. MATERIALS AND METHODS: Records of 146 children with cancer who died at Children's Hospital were reviewed for demographics, diagnosis, location of death, withdrawal of life support, use of "do not resuscitate" (DNR) orders, and the length of time that those orders were in effect. RESULTS: Ninety-five patients were evaluated. Fifty-nine died of progressive disease and 36 deaths were therapy-related. Sixty-four percent of disease-related deaths occurred at home with support from home care or hospice. Only 10% of all patients died while receiving maximal aggressive support in the intensive care unit. Age, diagnosis (solid tumor vs. leukemia), cause of death, length of last hospital admission, and the duration of DNR orders had a significant correlation with the place of death and referral to and use of hospice. Thirty-five percent of all patients had hospice support. CONCLUSIONS: Most children who die of cancer die because of progressive disease at home with hospice support. Do not resuscitate orders were written for most patients who died. End-of-life decisions are influenced by patient diagnosis, cause of death, and age.
2001
Adolescent
Adult
Backlog
Cause Of Death
Child
Clark C
Death and Euthanasia
Decision Making
Empirical Approach
Female
home care services
Hospice Care
Humans
Hutchison C
Infant
Journal Article
Journal Of Pediatric Hematology/oncology
Klopfenstein KJ
Location Of Death
Male
Neoplasms/complications/therapy
Preschool
Resuscitation Orders
Ruymann FB
Terminal Care/trends
Withholding Treatment
Young D
-
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://doi.org/10.1056/NEJM200002033420506" target="_blank" rel="noreferrer">http://doi.org/10.1056/NEJM200002033420506</a>
<a href="http://dx.doi.org/10.1056/NEJM200002033420506" target="_blank" rel="noreferrer">http://dx.doi.org/10.1056/NEJM200002033420506</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 and Suffering at the End of Life in Children with Cancer
Publisher
An entity responsible for making the resource available
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
Child; Humans; Terminal Care; Health Care Surveys; Parents; Withholding Treatment; Logistic Models; Questionnaires; Physicians; Boston; Longitudinal Studies; Quality of Health Care; quality of life; Empirical Approach; Non-U.S. Gov't; P.H.S.; Professional Patient Relationship; Research Support; U.S. Gov't; Death and Euthanasia; Psychological; Stress; Clodronate; Neoplasms/complications/therapy; Oncology at EOL; Pain/etiology/therapy; Anorexia/etiology/therapy; home care services; Children's Hospital (Boston); Constipation/etiology/therapy; Dana-Farber Cancer Institute (Boston); Diarrhea/etiology/therapy; Dyspnea/etiology/therapy; Fatigue/etiology/therapy; Palliative Care/standards/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Wolfe J; Grier Holcombe E; Klar Neil; Levin SB; Ellenbogen JM; Salem-Schatz S; Emanuel EJ; Weeks Jane C
Description
An account of the resource
Cancer is the leading cause of nonaccidental death in childhood.1 There has, however, been little evaluation of the overall experience at the end of life of children who are dying of cancer or of their symptoms other than pain.2,3 A number of studies have demonstrated that among adults, the quality of care at the end of life is suboptimal.4–8 For example, one study of elderly patients found that there was considerable suffering at the end of life, with up to 25 percent of patients experiencing moderate-to-severe pain in the last three days of life.7 It is not known . . .
2000-02
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1056/NEJM200002033420506" target="_blank" rel="noreferrer">10.1056/NEJM200002033420506</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
Anorexia/etiology/therapy
Backlog
Boston
Child
Children's Hospital (Boston)
Clodronate
Constipation/etiology/therapy
Dana-Farber Cancer Institute (Boston)
Death and Euthanasia
Diarrhea/etiology/therapy
Dyspnea/etiology/therapy
Ellenbogen JM
Emanuel EJ
Empirical Approach
Fatigue/etiology/therapy
Grier Holcombe E
Health Care Surveys
home care services
Humans
Journal Article
Klar Neil
Levin SB
Logistic Models
Longitudinal Studies
Neoplasms/complications/therapy
New England Journal Of Medicine
Non-U.S. Gov't
Oncology at EOL
P.H.S.
Pain/etiology/therapy
Palliative Care/standards/statistics & Numerical Data
Parents
Physicians
Professional Patient Relationship
Psychological
Quality Of Health Care
Quality Of Life
Questionnaires
Research Support
Salem-Schatz S
Stress
Terminal Care
U.S. Gov't
Weeks Jane C
Withholding Treatment
Wolfe 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://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=1524334&site=ehost-live&scope=site" target="_blank" rel="noreferrer">http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=1524334&site=ehost-live&scope=site</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
Effects of offering advance directives on medical treatments and costs
Publisher
An entity responsible for making the resource available
Annals Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1992
Subject
The topic of the resource
Humans; Personal Autonomy; Withholding Treatment; Prospective Studies; California; Hospitals; Empirical Approach; Professional Patient Relationship; Death and Euthanasia; DNAR Outcomes; Resource Allocation; Health Care and Public Health; Veterans; University; Advance Directives/ec [Economics]; Advance Directives/psychology; California Durable Power of Attorney for Health Care; Control Groups; Cost Control/methods; Life Support Care/utilization; Life Support Care/economics; Patient Satisfaction/statistics & numerical data; Risk Assessment
Creator
An entity primarily responsible for making the resource
Schneiderman LJ; Kronick R; Kaplan RM; Anderson JP; Langer RD
Description
An account of the resource
Objective: To examine the effects of advance directives on medical treatments and on patient satisfaction and well-being and to determine whether the enhancement of patient autonomy through advance directives provides a more ethically feasible approach to cost control than does the imposition of limits through rationing.; Design: Randomized, controlled trial.; Setting: University and Veterans Affairs medical center.; Patients: Two hundred and four patients with life-threatening illnesses, 100 of whom died after enrollment in the study.; Intervention: Patients randomly assigned to the experimental group were offered the California Durable Power of Attorney (a typical proxy-instruction directive), and patients assigned to the control group were not offered the advance directive. Hospital admissions were monitored to assure that a summary of the document was present in the active medical record at each hospitalization.; Measurements: Cognitive function, patient satisfaction, psychological well-being, health locus of control, sense of coherence, health-related quality of life, receipt of medical treatments, and medical treatment charges.; Results: No significant differences were found between advance-directive and control groups regarding psychosocial variables, health outcome variables, and medical treatments or charges. Patients offered an advance directive had an average hospital stay of 40.8 days (95% CI, 32.2 to 49.4 days), compared with an average of 33.1 days (95% CI, 26.0 to 40.2 days) for controls. Patients offered an advance directive were charged an average of $19,502 (95% CI, $13,030 to $25,974) for medical treatments in the last month of life compared with $19,700 (95% CI, $13,704 to $25,696) for controls.; Conclusions: Despite claims that public demand for longer life accounts for rising medical costs, most surveys suggest that patients are calling for less, not more, of the expensive, high-technology treatment often used in terminal phases of illness. Executing the California Durable Power of Attorney for Health Care and having a summary copy placed in the patient's medical record had no significant positive or negative effect on a patient's well-being, health status, medical treatments, or medical treatment charges.;
1992-10
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
1992
Advance Directives/ec [Economics]
Advance Directives/psychology
Anderson JP
Annals Of Internal Medicine
Backlog
California
California Durable Power of Attorney for Health Care
Control Groups
Cost Control/methods
Death and Euthanasia
DNAR Outcomes
Empirical Approach
Health Care and Public Health
Hospitals
Humans
Journal Article
Kaplan RM
Kronick R
Langer RD
Life Support Care/economics
Life Support Care/utilization
Patient Satisfaction/statistics & Numerical Data
Personal Autonomy
Professional Patient Relationship
Prospective Studies
Resource Allocation
Risk Assessment
Schneiderman LJ
University
Veterans
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=1373053" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=1373053</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
Terminal dehydration, a compassionate treatment
Publisher
An entity responsible for making the resource available
Archives Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1992
Subject
The topic of the resource
Female; Male; Palliative Care; Adult; Aged; Fluid Therapy; Enteral Nutrition; Parenteral Nutrition; 80 and over; Psychological; Human; Case Report; Withholding Treatment; Terminal Care/standards; Risk Assessment; Stress
Creator
An entity primarily responsible for making the resource
Printz LA
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
1992
1992
80 And Over
Adult
Aged
Archives Of Internal Medicine
Backlog
Case Report
Enteral Nutrition
Female
Fluid Therapy
Human
Journal Article
Male
Palliative Care
Parenteral Nutrition
Printz LA
Psychological
Risk Assessment
Stress
Terminal Care/standards
Withholding Treatment