Clinical report--Forgoing medically provided nutrition and hydration in children

Title

Clinical report--Forgoing medically provided nutrition and hydration in children

Creator

Diekema DS; Botkin JR; Committee on Bioethics; American Academy of Pediatrics

Publisher

Pediatrics

Date

2009

Subject

Child; Humans; infant; United States; Adult; Ethics; Medical; adolescent; Preschool; infant; Newborn; Disabled Children/legislation & jurisprudence; Feeding Methods/ethics; Fluid Therapy/ethics; Legal Guardians/legislation & jurisprudence; Medical Futility/ethics/legislation & jurisprudence; Risk Assessment/legislation & jurisprudence; Terminal Care/ethics/legislation & jurisprudence; Treatment Refusal/ethics/legislation & jurisprudence; Withholding Treatment/ethics/legislation & jurisprudence

Description

There is broad consensus that withholding or withdrawing medical interventions is morally permissible when requested by competent patients or, in the case of patients without decision-making capacity, when the interventions no longer confer a benefit to the patient or when the burdens associated with the interventions outweigh the benefits received. The withdrawal or withholding of measures such as attempted resuscitation, ventilators, and critical care medications is common in the terminal care of adults and children. In the case of adults, a consensus has emerged in law and ethics that the medical administration of fluid and nutrition is not fundamentally different from other medical interventions such as use of ventilators; therefore, it can be forgone or withdrawn when a competent adult or legally authorized surrogate requests withdrawal or when the intervention no longer provides a net benefit to the patient. In pediatrics, forgoing or withdrawing medically administered fluids and nutrition has been more controversial because of the inability of children to make autonomous decisions and the emotional power of feeding as a basic element of the care of children. This statement reviews the medical, ethical, and legal issues relevant to the withholding or withdrawing of medically provided fluids and nutrition in children. The American Academy of Pediatrics concludes that the withdrawal of medically administered fluids and nutrition for pediatric patients is ethically acceptable in limited circumstances. Ethics consultation is strongly recommended when particularly difficult or controversial decisions are being considered.
2009

Rights

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

Journal Article

Citation List Month

Backlog

Pages

813-822

Issue

2

Volume

124

Citation

Diekema DS; Botkin JR; Committee on Bioethics; American Academy of Pediatrics, “Clinical report--Forgoing medically provided nutrition and hydration in children,” Pediatric Palliative Care Library, accessed October 21, 2021, https://pedpalascnetlibrary.omeka.net/items/show/13963.

Social Bookmarking