title: Opinions of members of the National Civil (Family Proceedings) and Criminal Courts in withholding or withdrawing of life support situations in pediatrics.
abstract: BACKGROUND
  The possibility of sustaining life functions makes it difficult to distinguish between a dying patient and a patient with chances of survival, raising a dilemma for everyone around them. On the one side, continuing with life support techniques that would only extend an irreversible process and result in physical and psychological damage and harm their dignity. On the other side, withholding or withdrawing life support without an adequate reflection and diagnostic-therapeutic effort which may lead to the death of a potentially recoverable child. In addition, making decisions in this context implies facing barriers that hinder the possibility of pursuing the patient's best interest. Among such barriers, the fear of litigation plays a major role. To what extent is this fear justified?
  
  
  OBJECTIVE
  To explore the opinions of the members of the National Judiciary regarding the approach to withholding or withdrawing of life support from a legal stance.
  
  
  METHODS
  Professionals working in the criminal, civil and forensic medicine settings. Semistructured survey on three hypothetical case histories that implied making a decision to withhold or withdraw life support.
  
  
  RESULTS
  One hundred and eighty-five surveys were distributed; 68 (36.76%) were partially completed and 51 (30.3%), in full. Twenty-eight (55%) survey respondents did not criminalize any of the three cases presented. Thirteen (25%) respondents considered that the decisions made in the three cases constituted a crime; 6 (12%), only in one case; and 4 (8%), in two out of the three. Crimes described by survey respondents included intentional homicide, wrongful death, and failure to render assistance.
  
  
  CONCLUSIONS
  Forty-five percent of survey respondents considered that decisions made involved some form of crime.
authors.affiliation: Comité Hospitalario de Ética, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina. jselandari@intramed.net.
authors.forename: Jorge O
authors.initials: JO
authors.lastname: Selandari
authors.affiliation: Comité Hospitalario de Ética, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: María S
authors.initials: MS
authors.lastname: Ciruzzi
authors.affiliation: Facultad de Derecho. Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Adriel J
authors.initials: AJ
authors.lastname: Roitman
authors.affiliation: Comité Hospitalario de Ética, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Ledesma
authors.affiliation: Comité Hospitalario de Ética, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Célica
authors.initials: C
authors.lastname: Menéndez
authors.affiliation: Comité Hospitalario de Ética, Hospital de Pediatría SAMIC "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Hernán O
authors.initials: HO
authors.lastname: García
mesh_terms: D001118:Argentina; D001293:Attitude to Death; D002648:Child; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D008020:Life Support Care / Q000331:legislation & jurisprudence*; D010372:Pediatrics / Q000331:legislation & jurisprudence*; D028761:Withholding Treatment / Q000331:legislation & jurisprudence*
keywords: Decision-making; Ethics; Legislation and jurisprudence; Pediatric intensive care unit; Withholding treatment