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Paeds SAQspain-palliative-and-end-of-life-care

Paeds SAQs · pain-palliative-and-end-of-life-care

Withholding and withdrawing life-sustaining treatment — formative SAQs

Formative SAQs on withholding and withdrawing life-sustaining treatment covering definition, classification, bedside pathway, red flags, documentation and family support.

20 marks30 min1 min readVerification in progress

Target exams

RACP General PaediatricsMRCPCH ClinicalRACP DWE
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Study tools

Target exams

RACP General PaediatricsMRCPCH ClinicalRACP DWE
Prompt
Withholding and withdrawing life-sustaining treatment: definition, shared decision-making, stepwise plan and escalation

SAQ 1 (10)

A six-month-old infant with severe hypoxic-ischaemic encephalopathy remains ventilator-dependent after a catastrophic out-of-hospital arrest. The intensive-care team judges that continued invasive support is not in the child's best interests; the parents ask that "everything be done". [1] [2]

a) Define the core problem in one sentence and state the governing ethical standard. (3 marks) [1]

b) Outline the classification axes you would use and why they change management. (3 marks) [1] [2]

c) List the red flags that would force senior, ethics or court escalation. (2 marks) [1]

d) Document the key elements you would write in the clinical record after the family meeting. (2 marks) [2]

Paediatrics Fellowship Pro

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You have read the opening of this SAQ. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship library.

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References6ShowHide
  1. [1]Larcher V et al. Making decisions to limit treatment in life-limiting and life-threatening conditions in children: a framework for practice. Arch Dis Child, 2015.PMID 25802250
  2. [2]Himelstein BP et al. Pediatric palliative care. N Engl J Med, 2004.PMID 15103002
  3. [3]Dworetz AR et al. Withholding or withdrawing life-sustaining treatment in extremely low gestational age neonates. Arch Dis Child Fetal Neonatal Ed, 2021.PMID 33082153
  4. [4]Gillam L et al. How Could Parents' Reasons Shift a Refusal of Treatment into the Zone of Parental Discretion?. Am J Bioeth, 2025.PMID 41108243
  5. [5]Vemuri S et al. Conceptualising paediatric advance care planning: a qualitative phenomenological study of paediatricians caring for children with life-limiting conditions in Australia. BMJ Open, 2022.PMID 35577468
  6. [6]Horridge KA et al. Advance Care Planning: practicalities, legalities, complexities and controversies. Arch Dis Child, 2015.PMID 25275088
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