Parental Views on Withdrawing Life-Sustaining Therapies in Critically Ill Children
Open Access
- 1 November 2009
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Pediatrics & Adolescent Medicine
- Vol. 163 (11), 986-992
- https://doi.org/10.1001/archpediatrics.2009.180
Abstract
Objective To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. Design Quantitative and qualitative analysis of semi-structured one-on-one interviews. Setting The PICUs at 2 tertiary care hospitals. Participants English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. Intervention Semi-structured one-on-one interviews. Results Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. Conclusion Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision.Keywords
This publication has 21 references indexed in Scilit:
- Parents' Reactions to Participating in Interviews about End-of-Life Decision MakingJournal of Palliative Medicine, 2006
- What influences parents??? decisions to limit or withdraw life support?*Pediatric Critical Care Medicine, 2005
- Parental perspectives on end-of-life care in the pediatric intensive care unitCritical Care Medicine, 2002
- End-of-life care in the pediatric intensive care unit after the forgoing of life-sustaining treatmentCritical Care Medicine, 2000
- Users' Guides to the Medical LiteratureJAMA, 2000
- Qualitative research in health care: Analysing qualitative dataBMJ, 2000
- Factors explaining variability among caregivers in the intent to restrict life-support interventions in a pediatric intensive care unitCritical Care Medicine, 1997
- How Good Is That Agreement?Epidemiology, 1996
- Modes of death in the pediatric intensive care unitCritical Care Medicine, 1993
- No resuscitation and withdrawal of therapy in a neonatal and a pediatric intensive care unit in CanadaThe Journal of Pediatrics, 1993