ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE
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2005年
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159卷
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09期
关键词:
D O I:
10.1001/archpedi.159.9.802
中图分类号:
R72 [儿科学];
学科分类号:
100202 ;
摘要:
Background: Most end-of-life decision-making studies have, until now, involved either the general population or newborn infants. Objective: To assess the frequency of end-of-life decisions preceding child death and the characteristics of the decision-making process in the Netherlands. Methods: Two studies were performed. The first was a death certificate study in which all 129 physicians reporting the death of a child aged between I and 17 years in the period August to December 2001 received a written questionnaire; the second was an interview study in which face-to-face interviews were held with 63 physicians working in pediatric hospital departments. Results: Some 36% of all deaths of children between the ages of I and 17 years during the relevant period were preceded by an end-of-life decision: 12% by a decision to refrain from potentially life-prolonging treatment; 21% by the alleviation of pain or symptoms with a possible life-shortening effect; and 2.7% by the use of drugs with the explicit intention of hastening death. The latter decision was made at the child's request in 0.7% and at the request of the family in 2% of cases. The interview study examined 76 cases of end-of-life decision making. End-of-life decisions were discussed with all 9 competent and 3 partly competent children, with the parents in all cases, with other physicians in 75 cases, and with nurses in 66 cases. Conclusions: While not inconsiderable, the percentage of end-of-life decisions was lower for children than for adults and newborn infants. Most children are not considered to be able to participate in the decision-making process. Decisions are generally discussed with parents and other caregivers and, if possible, with the child.
机构:
Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, FranceHop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Vidal, M.
Jacquot, A.
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机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Jacquot, A.
Mesnage, R.
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h-index: 0
机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Mesnage, R.
Milesi, C.
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h-index: 0
机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Milesi, C.
Lemaitre, A.
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机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Lemaitre, A.
Cabirou, S.
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机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Cabirou, S.
Perotin, V.
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机构:
Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, FranceHop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Perotin, V.
Picaud, J. -C.
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机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
Picaud, J. -C.
Cambonie, G.
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机构:Hop Arnaud de Villeneuve, CHU Montpellier, Unite Mobile Soins Palliatifs, Montpellier, France
机构:
Vrije Univ Brussel, Dept Med Sociol, End Of Life Care Res Grp, B-1090 Brussels, Belgium
Univ Ghent, Bioeth Inst Ghent, B-9000 Ghent, BelgiumVrije Univ Brussel, Dept Med Sociol, End Of Life Care Res Grp, B-1090 Brussels, Belgium
Pousset, Geert
Bilsen, Johan
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机构:Vrije Univ Brussel, Dept Med Sociol, End Of Life Care Res Grp, B-1090 Brussels, Belgium
Bilsen, Johan
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机构:
Cohen, Joachim
Chambaere, Kenneth
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h-index: 0
机构:Vrije Univ Brussel, Dept Med Sociol, End Of Life Care Res Grp, B-1090 Brussels, Belgium
Chambaere, Kenneth
Deliens, Luc
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机构:
Vrije Univ Amsterdam Med Ctr, Expertise Ctr Palliat Care, Inst Hlth & Care Res, Dept Publ & Occupat Hlth,Extramuraal Geneeskundig, Amsterdam, NetherlandsVrije Univ Brussel, Dept Med Sociol, End Of Life Care Res Grp, B-1090 Brussels, Belgium
Deliens, Luc
Mortier, Freddy
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机构:
Univ Ghent, Bioeth Inst Ghent, B-9000 Ghent, BelgiumVrije Univ Brussel, Dept Med Sociol, End Of Life Care Res Grp, B-1090 Brussels, Belgium