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J Med Ethics 32:21-23 doi:10.1136/jme.2005.011700
  • Clinical ethics

Should children’s autonomy be respected by telling them of their imminent death?

  1. T Vince,
  2. A Petros
  1. Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, WC1N 3JH, UK
  1. Correspondence to:
 T Vince
 Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, WC1N 3JH, UK; VinceT1{at}gosh.nhs.uk
  • Received 12 January 2005
  • Accepted 20 April 2005
  • Revised 19 April 2005

Abstract

Respect for an individual’s autonomy determines that doctors should inform patients if their illness is terminal. This becomes complicated when the terminal diagnosis is recent and death is imminent. The authors examine the admission to paediatric intensive care of an adolescent with terminal respiratory failure. While fully ventilated, the patient was kept sedated and comfortable but when breathing spontaneously he was capable of non-verbal communication and understanding. Once resedated and reintubated, intense debate ensued over whether to wake the patient to tell him he was going to die. The authors discuss the ethical arguments that surrounded their decision.

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