| Clinical report--Forgoing medically provided nutrition and hydration in children. | |
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MedLine Citation:
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PMID: 19651596 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is broad consensus that withholding or withdrawing medical interventions is morally permissible when requested by competent patients or, in the case of patients without decision-making capacity, when the interventions no longer confer a benefit to the patient or when the burdens associated with the interventions outweigh the benefits received. The withdrawal or withholding of measures such as attempted resuscitation, ventilators, and critical care medications is common in the terminal care of adults and children. In the case of adults, a consensus has emerged in law and ethics that the medical administration of fluid and nutrition is not fundamentally different from other medical interventions such as use of ventilators; therefore, it can be forgone or withdrawn when a competent adult or legally authorized surrogate requests withdrawal or when the intervention no longer provides a net benefit to the patient. In pediatrics, forgoing or withdrawing medically administered fluids and nutrition has been more controversial because of the inability of children to make autonomous decisions and the emotional power of feeding as a basic element of the care of children. This statement reviews the medical, ethical, and legal issues relevant to the withholding or withdrawing of medically provided fluids and nutrition in children. The American Academy of Pediatrics concludes that the withdrawal of medically administered fluids and nutrition for pediatric patients is ethically acceptable in limited circumstances. Ethics consultation is strongly recommended when particularly difficult or controversial decisions are being considered. |
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Authors:
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Douglas S Diekema; Jeffrey R Botkin; |
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Publication Detail:
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Type: Journal Article Date: 2009-07-27 |
Journal Detail:
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Title: Pediatrics Volume: 124 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-08-04 Completed Date: 2009-08-13 Revised Date: 2010-12-30 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: 813-22 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Child, Preschool Disabled Children / legislation & jurisprudence Ethics, Medical* Feeding Methods / ethics* Fluid Therapy / ethics* Humans Infant Infant, Newborn Legal Guardians / legislation & jurisprudence Medical Futility / ethics, legislation & jurisprudence Risk Assessment / legislation & jurisprudence Terminal Care / ethics*, legislation & jurisprudence Treatment Refusal / ethics, legislation & jurisprudence United States Withholding Treatment / ethics*, legislation & jurisprudence |
| Investigator | |
Investigator/Affiliation:
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Douglas S Diekema / ; Armand H Matheny Antommaria / ; Ian R Holzman / ; Aviva I Katz / ; Steven R Leuthner / ; Lainie Friedman Ross / ; Sally A Webb / ; Jeffrey Botkin / ; Philip Baese / ; Marcia Levetown / ; Anne D Lyerly / ; Ellen Tsai / ; Jessica Wilen Berg / ; Alison Baker / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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