RT Journal
A1 Michelson K, Koogler T, Sullivan C, Ortega M, Hall E, Frader J
T1 PArental views on withdrawing life-sustaining therapies in critically ill children
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2009
FD November 1
VO 163
IS 11
SP 986
OP 992
DO 10.1001/archpediatrics.2009.180
UL http://dx.doi.org/10.1001/archpediatrics.2009.180
AB 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.