Decision making in extreme situations involving children:withholding or withdrawal of life supporting treatment in paediatric care. Statement of the ethics working group of the Confederation of the European Specialists of Paediatrics (CESP)

Paediatricians increasingly find themselves in situations in which decisions must be made regarding withholding or withdrawing life-supporting treatment in the care of a paediatric patient. There comes a point when the artificial prolongation of life only contributes to extending the act of dying and with it the suffering of the patient, parents/guardians, family, and caregivers. Life is the most precious gift. Every person, every child, has the right to live. Similarly, every person, every child, has the right to die with dignity. The paediatrician has an obligation to each patient to preserve life, promote health, and treat illness. In recent years the capacity of medicine to prolong life has increased exponentially. In situations that are extremely burdensome, and where there is no chance for effective therapy, the paediatrician has an obligation to protect the dignity of the patient in the act of dying.