Ethics and the care of critically ill infants and children

The ability to provide life support to ill children who, not long ago, would have died despite medicine's best efforts challenges pediatricians and families to address profound moral questions. Our society has been divided about extending the life of some patients, especially newborns and older infants with severe disabilities. The American Academy of Pediatrics (AAP) supports individualized decision making about life-sustaining medical treatment for all children, regardless of age. These decisions should be jointly made by physicians and parents, unless good reasons require invoking established child protective services to contravene parental authority. At this time, resource allocation (rationing) decisions about which children should receive intensive care resources should be made clear and explicit in public policy, rather than be made at the bedside.