PO-0318 Team–family Conflicts In Decisions To Forgo Life-sustaining Treatment (lst) In Picu

Title

PO-0318 Team–family Conflicts In Decisions To Forgo Life-sustaining Treatment (lst) In Picu

Creator

Dalichoux B; Bordet F; Javouhey E

Publisher

Archives Of Disease In Childhood

Date

2014

Description

Background and aims Many sources of conflict exist in intensive care units between family’s members, team–family, or within the ICU team. These conflicts are frequents (48%) in adults ICU, and most are in relation to end-of-life decisions especially with decisions to forgo LST. In PICU, no study has previously reported the prevalence, characteristics and effects of these conflicts. Methods We conducted a retrospective observational study of children admitted to PICU of Lyon, France, for whom a meeting to forgo LST had been held between October 1st 2010 and February 28th 2014. We search in medical record if conflict or disagreement were noticed and we interviewed the referent physician about conflict. We distinguished simple disagreement (quickly resolved), continuing disagreement (parents refuse recommendations with communication still possible), and conflict (communication impossible). Results For 72 children (31 girls, 41 boys), 91 decision-making meetings were organised. We identified 27.7% (20/72) disagreements or conflicts: 4 simple disagreements, 12 continuing disagreements and 4 conflicts. Five children had acute disease and 15 children had chronic disease. Source of disagreements was continuing LST in 19 cases (families wanted to continue aggressive treatment). In 1 case, the family wanted to stop treatments despite medical opinion (refusal of tracheotomy). Consequences of theses disagreements were continuation of treatments despite LST decisions in 12 cases. For 3 cases a compromise solution was found. Conclusion Disagreements are frequent in decisions to forgo LST (27,7%) and most of the child undergo treatments that are medically futile.
2014-10

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

A347-A348

Volume

99

Citation

Dalichoux B; Bordet F; Javouhey E, “PO-0318 Team–family Conflicts In Decisions To Forgo Life-sustaining Treatment (lst) In Picu,” Pediatric Palliative Care Library, accessed August 5, 2021, https://pedpalascnetlibrary.omeka.net/items/show/14855.

Social Bookmarking