Withholding aggressive seizure treatment from a child with severe intractable epilepsy: a case study.
A child with severe intractable epilepsy, profound neurological impairment, and frequent and lengthy admissions to the hospital for repeated and prolonged status epilepticus has an uncertain quality of life. The benefit and ethics of repetitive, aggressive seizure treatment are in question. This case study describes a healthcare team's experience when it was decided to withhold aggressive seizure treatment from a child with severe intractable epilepsy and transition to a palliative care approach. The situation leading up to this decision and the ethical dilemmas, nursing issues and interventions, and lessons learned are reviewed.
Boyd
Jennifer R
JR
Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada. jennifer.boyd@sickkids.ca
Hebbard
Mara
M
D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D009739:Nursing Services; D010166:Palliative Care / Q000379:methods; D016079:Refusal to Treat / Q000941:ethics*; D012720:Severity of Illness Index