Parental views on withdrawing life-sustaining therapies in critically ill children

Kelly Nicole Michelson, Tracy Koogler, Christine Sullivan, María Del Pilar Ortega, Emily Hall, Joel Frader

Research output: Contribution to journalArticle

54 Scopus citations

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 semistructured 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 lifesustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physicianestimated 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 lifesustaining therapies for their children and what factors might influence such a decision.

Original languageEnglish (US)
Pages (from-to)986-992
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Volume163
Issue number11
DOIs
StatePublished - Nov 2009

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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