Limitation of the therapeutic effort in pediatric intensive care Limitación del esfuerzo terapéutico en cuidados intensivos pediátricos

© 2014 Sociedad Chilena de Pediatría. Pediatric intensive care is a relatively new medical specialty, which has experienced signiicant technological advances in recent years. These developments have led to a prolongation of the dying process, with additional suffering for patients and their families, creating complex situations, and often causing a painful life extension. The term, limitation of the therapeutic effort refers to the adequacy and/or proportionality of the treatment, trying to avoid obstinacy and futility. The English literature does not talk about limitation of treatments, but instead the terms, withholding or withdrawal of life-sustaining treatment, are used. The removal or the non-installation of certain life support measures and the absence of CPR are the types of limitation most used. Also, there is evidence of insuficient medical training in bioethics, which is essential, as most doctors in the PICU discuss and make decisions regarding the end of life without the o