Forgoing life support: how the decision is made in European pediatric intensive care units


Forgoing life support: how the decision is made in European pediatric intensive care units


Devictor DJ; Latour JM


Intensive Care Medicine




Decision Making; Intensive Care Units Pediatric; Life Support Care; Withholding Treatment/sn [statistics & Numerical Data]; Child Preschool; Europe; Female; France; Health Care Surveys; Humans; Male; Prospective Studies; Surveys And Questionnaires; Terminal Care/td [trends]


PURPOSE: To determine how decisions to forgo life support are made in European pediatric intensive care units (PICUs). METHODS: A multicenter, prospective study, the Eurydice II study, among 45 PICUs: 20 in France, 21 in Northern/Western (N/W) European countries, and 4 in Eastern/Central (E/C) Europe. Data were collected between November 2009 and April 2010 through a questionnaire. RESULTS: The decision to forgo life-sustaining treatment was made in 166 (40.6%) out of 409 deceased children (median 42.9%, France 38.2%, N/W European countries 60.0%, E/C European countries 0%; P < 0.001). In the E/C group, more patients died after cardiopulmonary resuscitation (CPR) failure than after forgoing life support (P < 0.001). In all PICUs, caregivers discussed the decision during a formal meeting, after which the medical staff made the final decision. The decision was often documented in the medical record (median 100%). The majority of the parents were informed of the final decision and were at the bedside during their child's death (median 100%). Decision to forgo life-sustaining treatment occurred in 40.6% of children, compared with 33% in Eurydice I. A high percentage of parents from France were now informed about the meeting and its conclusion as compared with Eurydice I (median 100%). CONCLUSIONS: The results of this study and comparison with the Eurydice I study (2002) show a trend towards standardization of end-of-life practices across N/W European countries and France in the past decade.


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).

Citation List Month

December 2017 List


Devictor, Denis J
Latour, Jos M
EURYDICE II study group
Clement de Clety S
Detaille T
Martens F
Biarent D
De Jaejer A
Duval E
Novak M
Maria M
Boeuf B
Blanc T
Villediau F
Cantagrel S
Delaporte B
Baraton L
Brissaud O
Le Bouedec S
Michel F
Milesi C
Betremieux P
Cremer R
Mitanchez D
Guilbert J
Renolleau S
Devictor D
Michaux C
Hubert P
Gayot A
Desprez P
Dobrzynski M
Anani D
Wiebe B
Haun C
Reiter K
Bosk A
Kumpf M
Magner C
Bentsen G
Viera M
Pisarcikova M
Sagat T
Rey Galan C
Esteban E
Edberg KE
Otterstedt U
Berger T
de Hoog M
de Gast-Bakker DH
Markhorst DG
Fraser J
Gajraj M
Brier J
Peters M
Tasker R
Marii A
Dobrota L
Aronskind E
Nazarov V
Comment in: Intensive Care Med. 2011 Nov;37(11):1723-4; PMID: 21965098


Devictor DJ; Latour JM, “Forgoing life support: how the decision is made in European pediatric intensive care units,” Pediatric Palliative Care Library, accessed December 4, 2023,