Ethical challenges with decisions to withhold or withdraw resuscitation in pediatric surgery

Providers often dispute the ethical equivalence of withholding and withdrawing care, despite theoretical frameworks that support equivalency. We highlight two cases, one where providers express concern with initiation of aggressive resuscitation and another where providers experience emotional distr...

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Bibliographic Details
Published in:Seminars in pediatric surgery 2021-10, Vol.30 (5), p.151096-151096, Article 151096
Main Authors: Carlisle, Erica M., Bagwell, Charles E.
Format: Article
Language:English
Subjects:
Do not resuscitate
Medical ethics
Pediatric surgery
Resuscitation limits
Withhold resuscitation
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Summary:Providers often dispute the ethical equivalence of withholding and withdrawing care, despite theoretical frameworks that support equivalency. We highlight two cases, one where providers express concern with initiation of aggressive resuscitation and another where providers experience emotional distress from the decision to cease resuscitation. Both cases illustrate how the ethical challenges encountered can result in high levels of provider distress. Mitigation of this moral distress by team members will require an improved understanding of available evidence in the literature and active discussion by debriefing after a child dies. Medical staff and national organizations can help recognize that these patient events contribute to provider burnout and facilitate the design and support of programs to increase provider resiliency.
ISSN:1055-8586
1532-9453
DOI:10.1016/j.sempedsurg.2021.151096