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Case Report 


Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease

Mohamad-Hani Temsah.

Abstract
Advances in critical care and technology capabilities may lead to new ethical encounters in paediatrics, especially in the paediatric intensive care unit (PICU). As each patient has unique psychosocial and clinical condition interactions, paediatricians and healthcare providers must develop and adopt a suitable approach for ethical decision-making in the PICU. The healthcare provider needs to balance the four ethical domains of autonomy, beneficence, non-maleficence and justice, and apply these principles to clinical decision-making. One chief factor for ethical decision-making is to have a patient-centered and family-oriented management that is respectful of cultural background. Healthcare providers also need to observe professional ethical conduct and the applicable national laws. Applying these ethical guidelines in paediatric care ensures a more holistic approach to care, whether in the paediatric wards or the highly technical environment of the PICU. We describe two situations in which the parents of twins with a confirmed lethal disease changed their attitude towards end-of-life from full support to “do not resuscitate” and palliative care, after experiencing the palliative care of the first twin, rather than the futile effect of cardiopulmonary resuscitation in the other twin.

Key words: Zellweger syndrome; Twins; Lethal disease; End-of-life care; Do not resuscitate; Ethics.


 
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Pubmed Style

Mohamad-Hani Temsah. Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. Sudan J Paed. 2018; 18(1): 76-82. doi:10.24911/SJP.2018.1.11


Web Style

Mohamad-Hani Temsah. Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. http://www.sudanjp.com/?mno=287273 [Access: December 10, 2018]. doi:10.24911/SJP.2018.1.11


AMA (American Medical Association) Style

Mohamad-Hani Temsah. Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. Sudan J Paed. 2018; 18(1): 76-82. doi:10.24911/SJP.2018.1.11



Vancouver/ICMJE Style

Mohamad-Hani Temsah. Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. Sudan J Paed. (2018), [cited December 10, 2018]; 18(1): 76-82. doi:10.24911/SJP.2018.1.11



Harvard Style

Mohamad-Hani Temsah (2018) Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. Sudan J Paed, 18 (1), 76-82. doi:10.24911/SJP.2018.1.11



Turabian Style

Mohamad-Hani Temsah. 2018. Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. Sudanese Journal of Paediatrics, 18 (1), 76-82. doi:10.24911/SJP.2018.1.11



Chicago Style

Mohamad-Hani Temsah. "Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease." Sudanese Journal of Paediatrics 18 (2018), 76-82. doi:10.24911/SJP.2018.1.11



MLA (The Modern Language Association) Style

Mohamad-Hani Temsah. "Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease." Sudanese Journal of Paediatrics 18.1 (2018), 76-82. Print. doi:10.24911/SJP.2018.1.11



APA (American Psychological Association) Style

Mohamad-Hani Temsah (2018) Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease. Sudanese Journal of Paediatrics, 18 (1), 76-82. doi:10.24911/SJP.2018.1.11





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