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Ethical, legal, and end-of-life decision-making 

Ethical, legal, and end-of-life decision-making
Chapter:
Ethical, legal, and end-of-life decision-making
Author(s):

Samiran Ray

, and Miriam R. Fine-Goulden

DOI:
10.1093/med/9780198794592.003.0012
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date: 13 April 2021

All of those working in paediatric intensive care will be faced with difficult decisions and will be looking after children at the end of their lives. Chapter 12 addresses the principles of medical ethics. It explains the assessment of ‘Gillick’ competence and obtaining consent from children, when to consider treatment limitation and involve the palliative care team, and, in some cases, where legal advice should be sought. Brainstem death is defined, and guidance is provided on how to perform brainstem death tests, including the use of ancillary tests and specific requirements for children under the age of 2 months. The chapter discusses end-of-life care in the Paediatric Intensive Care Unit, including organ donation in children. The final scenario explores the role of the intensivist in resource allocation decision-making and intensive care triage.

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