The revised Royal College of Paediatric and Child Health guidance on making decisions to limit treatment in life-limiting and life-threatening conditions in childhood has just been published. It provides an ethical and legal framework for practicing clinicians revised to reflect the changes in the scope and availability of advanced technology and in the emphasis and application of ethical and legal principles in decision making.
The document sets out the circumstances under which withholding or withdrawing life sustaining treatment might be ethically permissible. In particular it describes situations in which individual children should be spared inappropriate invasive procedures. The document sets out three sets of circumstances when treatment limitation can be considered
- because it is no longer in the child’s best interests to continue
- because it cannot provide overall benefit – firstly when life is limited in quantity, secondly when life is limited in quality
- informed competent refusal of treatment.
The document covers the ethical and legal framework and the process of decision making and the practical aspects in detail. It is a very powerful document which will help professionals and families of children with complex medical disorders in their desire and responsibility to act in the best interests of the child.
We would like to hear your responses to the document; as considered comments on this blog, on our facebook page, or (if you’re really concise) via Twitter
– @RMBeatie50