JUST BECAUSE WE CAN, DOES NOT MEAN WE SHOULD
Abstract
Background
Dying from natural cause has become an exception in pediatrics. Mechanical ventilation and other medical and technological interventions keep patients alive and most recover. With technological progress, the ethical issues that arise in the intensive care units have become even more complex. Is prolonging life for children with complex and technology-dependent conditions always appropriate? Intensive care doctors must initiate discussions with families about how they view a good death or their child’s quality of life, and use this information in the decision-making process. But how?
Objectives
To help both doctors make difficult decisions within the ethical gray zone
Methods
Analysis of complex decision-making in the NICU and PICU and sugestions for improvement
Results
Parents as well as healthcare providers know, that just because we can, does not mean we should invoke all available medical and technical interventions in every situation. The use of technology needs to be guided by firm ethical principles and requires good communication skills. Recent developments in shared decision-making recommend that doctors involve parents in decision-making by helping them discern their own values and ethical commitments. Doctors should learn to acknowledge that there is no simple way to present facts and ask parents open-ended questions about their hopes, fears, goals, and values and then listen carefully. At the same time, doctors too have emotions and values.
Conclusion
Doctors who have difficult conversations with parents require skills that can be taught and can be learned. These skills will ultimately improve the quality of care for children in the NICU and the PICU.
POST-INTENSIVE CARE SYNDROME
Presentation files
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5 ESPNIC 2019- Manning - Post intensive care syndrome- 21-6-2019 21.06.2019 12:17