[3] At the time of the study, only 19.6% of the available ICU beds were dedicated to paediatric or neonatal patients.01 In SA, the disparity between public and private sector resources adds to the intensivist's dilemma, because rationing, withholding and
withdrawal of care are routine for the majority of the population, but do not generally apply to those who can afford private healthcare.
The inquest heard the boy was gravely ill before being transferred after 8am to the Rotunda in Dublin where
withdrawal of care was recommended.
For patients with medical decision-making capacity, it could 1) include
withdrawal of care at a patient's insistence or periods of intermittent sedation--which is used in palliative medicine for patients with intractable pain; or 2) mean switching a patient with end-stage anorexia and multiple failed treatment attempts to hospice care rather than force feeding, Dr.
Other times, we explicitly construct four-box models (Schumann & Alfandre, 2008) as we deliberate complex questions about decision-making rights, the age of functional competency, and
withdrawal of care.
As well as providing nursing care to sick and premature babies and their families, she also has a specialist role within the unit in
Withdrawal of Care and Bereavement.
We oppose the non-consensual withholding or
withdrawal of care or treatment, including food and water, from individuals with disabilities, newborns, the elderly, or the infirm, just as we oppose euthanasia and assisted suicide.
* Open and gentle communication with the family in a private space, and avoiding the use of terms like "
withdrawal of care".
Once established, the plan of
withdrawal of care is in place, including food, hydration, and life-sustaining medical measures.
End-of-Life Care--Nursing Education --Simulation--Perceived Competence
Withdrawal of CareThere are easily conceived scenarios in which a lack of action would constitute a
withdrawal of care. For instance, a decision to not refill an IV bag while leaving the IV line in place, or to cease artificial nutrition through a feeding tube while leaving the tube in place, could both be considered withdrawals of life-sustaining care.
CACCN advocated for shared decision-making on end-of-life care and
withdrawal of care. If disagreement arises, the option of a third-party decision-making body should be available to resolve the conflict.
Interestingly, in the case known as Baby M, Justice Ross determined that the trend in written decisions "reflects a general societal understanding that life without awareness and totally supported by machines is not in accordance with the best interests of any patient." (22) The law of informed consent should not govern the determination of the
withdrawal of care deemed by the medical team as not clinically indicated, futile or harmful.
