Ethical Thinking and Palliative Approach Integrated at French Paediatric Intensive Care Unit in 2017

Abstract

In pediatric intensive care unit (PICU), 40% of deaths occur after a withholding or withdrawing life sustaining treatment (WLST) decision. These situations are often the source of ethical dilemmas among members of the health care team. French law and clinical guidelines established by academic societies provide a framework for PICU caregivers during WLST decisions. National surveys show that they have appropriated some of the collegial procedures like pluri-professional concertation, information and communicationwith the parents. Nevertheless, some points such as the presence of the consultant, the reality of the collegiality with each present person’s expression are not routinely done. The parents’ place during the decision making also must be thought. The collaboration PICU team and palliativemedicine team appear as a possibility to improve yet the quality of the care and the accompanying which are proposed. Those collaborations also enlarge the possibility of ethical thinking needed during the end of life or a complex situation. Additional efforts in PICU professionals training are desirable as well as the development of a regular collaboration with palliative medicine professionals.