Withdrawal of life support

Decisions regarding the limitation or withdrawal of life-sustaining therapies for critically ill children are intellectually and emotionally difficult. A working knowledge of the basic principles of biomedical ethics and their compassionate application are needed to guide the decision-making process. Health professionals and families must work together to achieve that which is in the best interest of the child. Optimal care during limitation or withdrawal of life support places a strong emphasis on palliation, which includes assessing the impact of each device, medication, and procedure on the comfort of the child. Additionally, the physical and emotional environment of the PICU can influence patients' and families' level of comfort at the time of death. Parents and families suffer greatly after the loss of a child. Follow-up of parents and families after a child's death is an important part of end-of-life care.