Ethical Issues of End of Life Decisions in Pediatrics

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: 15 October 2024 | Viewed by 3325

Special Issue Editor


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Guest Editor
1. Neonatology Section, Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Šlajmerjeva 3, 1000 Ljubljana, Slovenia
2. Department of Paediatrics, Faculty of Medicine, University of Ljubljana Bohoričeva 20, 1000 Ljubljana, Slovenia
Interests: critically ill newborn infants and children; transportation medicine; medical and research ethics; adult, pediatric and neonatal intensive care medicine; palliative care medicine; philosophy; medical ethics

Special Issue Information

Dear Colleagues,

End-of-life (EOL) decision making is a process of recognizing that further treatment of a patient, whether it is in the intensive care unit or in the ward, is only serving to prolong life without being in the patient’s best interest. The forgoing of life support treatment (LST) when the EOL is approaching and moving from curative to palliative care is ethically one of the most difficult decisions for health care professionals. “Withholding” means not introducing new treatment options and intensifying treatment options that a patient is already undergoing; meanwhile, “withdrawing” refers to discontinuing treatment that a patient is already undergoing.

Different practices regarding the implementation of EOL decisions and forgoing LST in pediatric patients can be found in the literature.

The aim of this Special issue is to gather articles from different parts of the world, both developed and underdeveloped countries, and to obtain information on how healthcare professionals (not only physicians but also registered nurses and others) approach and solve ethical dilemmas and make final ethical decisions on EOL and forgoing LST.

We believe that varieties in our EOL decisions enrich our knowledge and improve mutual understanding between different approaches all over the world, and help to better understand the value of life—especially children’s lives—when no treatment besides palliative care is possible.

Prof. Dr. Štefan Grosek
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • forgoing life support treatment (LST)
  • end-of-life decision (EOL)
  • ethics
  • children
  • infants
  • palliative care
  • withholding
  • withdrawing

Published Papers (1 paper)

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Review

11 pages, 286 KiB  
Review
Ethical Dilemmas in Neonatal Care at the Limit of Viability
by Lilijana Kornhauser Cerar and Miha Lucovnik
Children 2023, 10(5), 784; https://0-doi-org.brum.beds.ac.uk/10.3390/children10050784 - 26 Apr 2023
Cited by 3 | Viewed by 2945
Abstract
Advances in neonatal care have pushed the limit of viability to incrementally lower gestations over the last decades. However, surviving extremely premature neonates are prone to long-term neurodevelopmental handicaps. This makes ethics a crucial dimension of periviable birth management. At 22 weeks, survival [...] Read more.
Advances in neonatal care have pushed the limit of viability to incrementally lower gestations over the last decades. However, surviving extremely premature neonates are prone to long-term neurodevelopmental handicaps. This makes ethics a crucial dimension of periviable birth management. At 22 weeks, survival ranges from 1 to 15%, and profound disabilities in survivors are common. Consequently, there is no beneficence-based obligation to offer any aggressive perinatal management. At 23 weeks, survival ranges from 8 to 54%, and survival without severe handicap ranges from 7 to 23%. If fetal indication for cesarean delivery appears, the procedure may be offered when neonatal resuscitation is planned. At a gestational age ≥24 weeks, up to 51% neonates are expected to survive the neonatal period. Survival without profound neurologic disability ranges from 12 to 38%. Beneficence-based obligation to intervene is reasonable at these gestations. Nevertheless, autonomy of parents should also be respected, and parental consent should be sought prior to any intervention. Optimal counselling of parents involves harmonized cooperation of obstetric and neonatal care providers. Every fetus/neonate and every pregnant woman are different and have the right to be considered individually when treatment decisions are being made. Full article
(This article belongs to the Special Issue Ethical Issues of End of Life Decisions in Pediatrics)
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