evidence and practice
In the child’s best interests: should life be sustained when further treatment is futile?
Emma Marland Staff nurse, neonatal department, Royal Victoria Infirmary, Newcastle upon Tyne, England
Barbara Davies Senior lecturer, children’s nursing, University of Northumbria, Newcastle upon Tyne, England
• To understand that medical advances have meant that children with complex diseases are living longer, but in some cases prolonging treatment may be deemed futile
• To understand the ethics involved in decisions about withholding or withdrawing treatment and the best interests of the child
• To recognise the importance of nurturing partnerships and encouraging parents to be involved in decision-making particularly about end of life care
The aim of this article is to explore the concept of medical futility and the withdrawal of care for children in intensive care units. There have been several recent cases where medical staff have considered that there was no possibility of recovery for a child, yet their clinical judgments were challenged by the parents. The private anguish of these families became public, social media heightened emotions and this was followed by political and religious intrusion.
Innovations in medical treatment and technological advances raise issues for all those involved in the care of children and young people especially when decisions need to be made about end of life care. Healthcare professionals have a moral and legal obligation to determine when treatment should cease in cases where it is determined to be futile. The aim should be to work collaboratively with parents but all decisions must be made in the best interests of the child. However, medical staff and parents may have differing opinions about care decisions. In part, this may be as a result of their unique relationships with the child and different understanding of the extent to which the child is in discomfort or can endure pain.
Nursing Children and Young People. doi: 10.7748/ncyp.2019.e1107Peer review
This article has been subject to open peer review and has been checked for plagiarism using automated softwareCorrespondence
Marland E, Davies B (2019) In the child’s best interests: should life be sustained when further treatment is futile? Nursing Children and Young People. doi: 10.7748/ncyp.2019.e1107
Published online: 22 October 2019