A series of recent high-profile court cases has demonstrated the inadequacy of current laws in addressing issues relating to medical treatment decisions involving seriously ill children. The challenges of determining that life-sustaining medical treatment is not in a young child’s best interests have resulted in criticism of the best interests principle. This book explores the theoretical foundations of the best interests principle, and alternatives offered in the academic literature, to allow readers to understand why the principle remains contentious despite its prevalence. It provides theoretical background, exploration of what occurs in practice, and proposes a novel approach to address these challenges. Frameworks for decision-making identified in the academic literature are used to examine the application of the best interests principle in practice in England and Wales, Australia, and New Zealand through a review of the case law and qualitative research with paediatric doctors. The exploration of current practice allows readers to understand the challenges of applying the best interests principle, but also the need to retain a focus on the child. Readers are introduced to a human-rights based approach, which ensures that the focus remains on upholding the child’s best interests but also provides a more comprehensive explanation of the situation. Progressing the debate around end-of-life decision-making and children, the book will be a valuable resource for academics, researchers and policy-makers. It will also provide practical guidance to both legal and medical practitioners in managing disputes about the provision of life-sustaining treatment.

What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents' wishes? The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world. In this book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict. From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new 'dissensus' framework for future cases of disagreement. - This new book critically examines the core ethical questions at the heart of disputes about medical treatment for children. - The contents review prominent cases of disagreement from the UK and internationally and analyse some of the distinctive and challenging features around treatment disputes in the 21st century. - The book proposes a radical new framework for future cases of disagreement around the care of gravely ill people.

This book examines the many ethical issues that are encountered in the Pediatric Intensive Care Unit (PICU). It supports pediatricians, nurses, residents, and other providers in their daily management of critically ill children with the dilemmas that arise. It begins by examining the evolution of pediatric critical care, and who is now impacted by this advancing medical technology. Subsequent chapters explore specific ethical concerns and controversies that are commonly encountered. These topics include how to conduct end-of-life discussions with families facing a myriad of challenging choices. It goes on to explore the concept of futility, and what that does and does not mean in the pediatric ICU setting. Controversial subjects such as children as organ donors, particularly using donation after cardiac death, in addition to issues surrounding the declaration of brain death are covered. Additional chapters address resource allocation, and also analyze the use of long-term technology in chronically critically ill children. Chapters include case examples with guidance on how to work through similar difficulties and decision-making. While this book is specifically targeted for care providers at the ICU bedside, it is also of benefit to medical students, students in bioethics, practicing ethical consultants and families who are dealing with critically ill children.

Now completely up to date to meet the needs of today's pediatric nurses, Mary Fran Hazinski's Nursing Care of the Critically Ill Child, 3rd Edition, remains the foundational text of pediatric critical care nursing. Known for its outstanding organization and clear descriptions, this comprehensive reference details the unique care required for critically ill children with thorough discussions of physiology, pathophysiology, pharmacology, collaborative management, and nursing management. Ten new chapters, new advanced practice content, and new nurse contributors and reviewers ensure that this classic text continues to be the essential resource for the care of critically ill children. Details differences in caring for critically ill children as compared with caring for adults: how to modify assessment procedures, consider aspects of psychosocial development, and examine developmental aspects of various body systems. Provides comprehensive coverage of physiology, pathophysiology, pharmacology, and nursing management related to care of the critically ill child. Includes detailed Nursing Care Plans for select disorders. Contains helpful appendices such as pediatric drug dosages, central venous catheter care, and pediatric fluid requirements. Features Evolve online resources with additional content for further study of related topics, including tables for ease of recollection of material and additional references. Contains 10 all-new chapters, including Pharmacokinetics and Pharmacodynamics; Shock, Cardiac Arrest, and Resuscitation; Mechanical Support of Cardiopulmonary Function; Fluid, Electrolyte, and Endocrine Problems; Immunology and Infectious Disorders; Transplantation and Organ Donation; Toxicology/Poisonings; Fundamentals of Quality Improvement and Patient Safety; Clinical Informatics; and Ethical Issues in Pediatric Critical Care Features nurse contributors and reviewers for every chapter, making this edition a truly collaborative text. Provides information vital to the advanced practice nurse, such as assessment tools and severity of illness management. Includes numerous Pearls that highlight practical wisdom from experts in pediatric critical care nursing.

The high profile cases of Charlie Gard, Alfie Evans, and Tafida Raqeeb raised the questions as to why the state intrudes into the exercise of parental responsibility concerning the medical treatment of children and why parents may not be permitted to decide what is in the best interests of their child. This book answers these questions. It argues for a reframing of the law concerned with the medical treatment of children to one which better protects the welfare of the individual child, within the context of family relationships recognising the duties which professionals have to care for the child and that the welfare of children is a matter of public interest, protected through the intervention of the state. This book undertakes a rigorous critical analysis of the case law concerned with the provision of medical treatment to children since the first reported cases over forty years ago. It argues that understanding of the cases only as disputes over the best interests of the child, and judicial resolution thereof, fails to recognise professional duties and public responsibilities for the welfare and protection of children that exist alongside parental responsibilities and which justify public, or state, intervention into family life and parental decision-making. Whilst the principles and approach of the court established in the early cases endure, the nature and balance of these responsibilities to children in their care need to be understood in the changing social, legal, and political context in which they are exercised and enforced by the court. The book will be a valuable resource for academics, students, and practitioners of Medical Law, Healthcare Law, Family Law, Social Work, Medicine, Nursing, and Bioethics.

The notion that children constitute an important group of rights holders has gained increasing acceptance both domestically and internationally. Nevertheless, this rhetorical commitment to children's rights is not necessarily realised in practice. Now in its fourth edition, Fortin's Children's Rights and the Developing Law explores the extent to which law and policy in England promotes or undermines the rights of children. Fully revised and updated, this textbook uses current research on child development and welfare to reflect on the extent to which the law fulfils children's rights in a wide range of areas, including medical law, education and child poverty. These developments are measured again the domestic law and the UK's international obligations under, for example, the United Nations Convention on the Rights of the Child.