Show simple item record

dc.contributor.authorKirsch, RE
dc.contributor.authorBalit, CR
dc.contributor.authorCarnevale, FA
dc.contributor.authorLatour, JM
dc.contributor.authorLarcher, V
dc.date.accessioned2018-02-09T20:14:42Z
dc.date.issued2018-08
dc.identifier.issn1947-3893
dc.identifier.issn1947-3893
dc.identifier.urihttp://hdl.handle.net/10026.1/10763
dc.description.abstract

<jats:p>As part of the invited supplement on Death and Dying in the PICU, we reviewed ethical, cultural, and social considerations for the bedside healthcare practitioner prior to engaging with children and families in decisions about limiting therapies, withholding, or withdrawing therapies in a PICU. Clarifying beliefs and values is a necessary prerequisite to approaching these conversations. Striving for medical consensus is important. Discussion, reflection, and ethical analysis may determine a range of views that may reasonably be respected if professional disagreements persist. Parental decisional support is recommended and should incorporate their information needs, perceptions of medical uncertainty, child’s condition, and their role as a parent. Child’s involvement in decision making should be considered, but may not be possible. Culturally attuned care requires early examination of cultural perspectives before misunderstandings or disagreements occur. Societal influences may affect expectations and exploration of such may help frame discussions. Hospital readiness for support of social media campaigns is recommended. Consensus with family on goals of care is ideal as it addresses all parties’ moral stance and diminishes the risk for superseding one group’s value judgments over another. Engaging additional supportive services early can aid with understanding or resolving disagreement. There is wide variation globally in ethical permissibility, cultural, and societal influences that impact the clinician, child, and parents. Thoughtful consideration to these issues when approaching decisions about limitation or withdrawal of life-sustaining therapies will help to reduce emotional, spiritual, and ethical burdens, minimize misunderstanding for all involved, and maximize high-quality care delivery.</jats:p>

dc.format.extentS10-S18
dc.format.mediumPrint
dc.languageen
dc.language.isoen
dc.publisherLippincott, Williams & Wilkins
dc.subjectbioethics
dc.subjectdecision-making support
dc.subjectend of life
dc.subjectpediatric critical care
dc.subjectwithdrawal of life-sustaining therapies
dc.titleEthical, cultural, social and individual considerations prior to transition to limitation or withdrawal of life-sustaining therapies
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/30080802
plymouth.issue8
plymouth.volume19
plymouth.publisher-urlhttp://dx.doi.org/10.1097/pcc.0000000000001488
plymouth.publication-statusPublished
plymouth.journalPediatric Critical Care Medicine
dc.identifier.doi10.1097/pcc.0000000000001488
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Nursing and Midwifery
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeUnited States
dcterms.dateAccepted2018-01-03
dc.rights.embargodate2019-8-1
dc.identifier.eissn1947-3893
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1097/pcc.0000000000001488
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-08
rioxxterms.typeJournal Article/Review


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record


All items in PEARL are protected by copyright law.
Author manuscripts deposited to comply with open access mandates are made available in accordance with publisher policies. Please cite only the published version using the details provided on the item record or document. In the absence of an open licence (e.g. Creative Commons), permissions for further reuse of content should be sought from the publisher or author.
Theme by 
Atmire NV