Jul 4, 2008

Withdrawal of life sustaining treatment in children in the first year of life

Journal of Perinatology : Official Journal of the California Perinatal Association
E B EasonJ W Sparks


Since the enactment of the Texas Advance Directives Act of 1999, the Memorial Hermann Hospital Medical Appropriateness Review Committee (MARC) MARC reviewed six cases of children in the first year of life, three from the Neonatal ICU and three from the Pediatric ICU. We aimed to describe the characteristics of these patients and the role of the MARC in this process. A single reviewer retrospectively reviewed the cases for patient diagnoses, demographics, related ethical issues and the actions of the MARC. Each of the six patients required life-sustaining therapy, and each patient had a Do Not Resuscitate order on the chart. The MARC determined that it would be appropriate to withdraw life-sustaining support in four of the cases and to continue support in two of the cases. Five of the patients died in the hospital before discharge: two after discontinuation of support, one during the 10-day waiting period, and two died on full support after the Committee determined that continued treatment was medically appropriate. One patient was transferred to another hospital during the 10-day waiting period. These cases document the application of the TADA/MARC process in infants, even in circumstances where care was withdrawn without concu...Continue Reading

  • References18
  • Citations3


  • References18
  • Citations3


Mentioned in this Paper

Pediatric Intensive Care Unit
Review Committees
Hospital Mortality
Withholding Resuscitation
Professional-Family Relations
Withdrawing Treatment
Bioethical Issues
Retrospective Studies
Pediatric Crohn's Disease
Intensive Care Units, Neonatal

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Bone Marrow Neoplasms

Bone Marrow Neoplasms are cancers that occur in the bone marrow. Discover the latest research on Bone Marrow Neoplasms here.

IGA Glomerulonephritis

IgA glomerulonephritis is a chronic form of glomerulonephritis characterized by deposits of predominantly Iimmunoglobin A in the mesangial area. Discover the latest research on IgA glomerulonephritis here.

Cryogenic Electron Microscopy

Cryogenic electron microscopy (Cryo-EM) allows the determination of biological macromolecules and their assemblies at a near-atomic resolution. Here is the latest research.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

LRRK2 & Immunity During Infection

Mutations in the LRRK2 gene are a risk-factor for developing Parkinson’s disease. However, LRRK2 has been shown to function as a central regulator of vesicular trafficking, infection, immunity, and inflammation. Here is the latest research on the role of this kinase on immunity during infection.

Antiphospholipid Syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.

Meningococcal Myelitis

Meningococcal myelitis is characterized by inflammation and myelin damage to the meninges and spinal cord. Discover the latest research on meningococcal myelitis here.

Alzheimer's Disease: MS4A

Variants within membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease by recent genome-wide association studies. Here is the latest research.

Related Papers

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Regina Okhuysen-CawleyLarry S Jefferson
The New England Journal of Medicine
Robert L Fine
American Journal of Medical Genetics. Part a
Dongzhi LiXuewei Tang
JAMA : the Journal of the American Medical Association
S J Youngner
© 2020 Meta ULC. All rights reserved