Low prevalence of palliative care and ethics consultations for children with chronic critical illness

Low prevalence of palliative care and ethics consultations for children with chronic critical illness

Xu L; Gao H; Zeng J; Liu J; Lu C; Guan X; Qian S; Xie Z

BMC Infectious Diseases

2018

Medical advances over the past two decades have increased the numbers of children who survive serious conditions. Mortality from pre-mature birth and genetic syndromes has improved such that more clinicians offer, and more families request, interventions to prolong their child’s life. While some interventions promise cure, others result in chronic disease states that require ongoing medical care. Paediatric intensive care units (ICUs) across the United States (U.S.) report increasing numbers of children with prolonged and recurrent hospitalisations and medical complexity(1). We have suggested that this population be considered ‘chronically critically ill (CCI)’ (2).The CCI designation for adult ICU patients signals to families and clinicians alike that thepatient’s prognosis is poorer than predicted by their primary diagnosis alone. Nelson et al. (3) have argued that palliative care can enhance care planning, communication and quality of life for patients with CCI. The ethical challenges that can arise for these patients, for example, conflicting values and treatment burdens, also highlight an obvious role for ethics consultation.

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July 2018 List