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The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy

The motion of the Italian National Bioethics Committee entitled “Aggressive treatment or therapeutic obstinacy on young children with limited life expectancy” comprises a premise that rejects therapeutic obstinacy and makes 12 recommendations. Recommendation no. 1 states the general rules: it ascrib...

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Autores principales: Bolcato, Matteo, Russo, Marianna, Feola, Alessandro, Della Pietra, Bruno, Tettamanti, Camilla, Bonsignore, Alessandro, Ciliberti, Rosagemma, Rodriguez, Daniele, Aprile, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712670/
https://www.ncbi.nlm.nih.gov/pubmed/33139649
http://dx.doi.org/10.3390/healthcare8040448
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author Bolcato, Matteo
Russo, Marianna
Feola, Alessandro
Della Pietra, Bruno
Tettamanti, Camilla
Bonsignore, Alessandro
Ciliberti, Rosagemma
Rodriguez, Daniele
Aprile, Anna
author_facet Bolcato, Matteo
Russo, Marianna
Feola, Alessandro
Della Pietra, Bruno
Tettamanti, Camilla
Bonsignore, Alessandro
Ciliberti, Rosagemma
Rodriguez, Daniele
Aprile, Anna
author_sort Bolcato, Matteo
collection PubMed
description The motion of the Italian National Bioethics Committee entitled “Aggressive treatment or therapeutic obstinacy on young children with limited life expectancy” comprises a premise that rejects therapeutic obstinacy and makes 12 recommendations. Recommendation no. 1 states the general rules: it ascribes a cardinal role to a shared care plan, it supports pain management therapy and pain relief, it opposes ineffective and disproportionate clinical treatment and defensive medicine. The other recommendations are correlated to the enacting of a national law establishing clinical ethics committees in paediatric hospitals; participation of parents and their fiduciaries in the decision-making processes; recourse to courts only as extrema ratio in the event of irremediable disagreement between the medical team and the family members; accompaniment at the end of life also through continuous deep sedation combined with pain therapy; access to palliative care; the need to reinforce research on pain and suffering in children; clinical trials and research studies conducted in children; the training of doctors, healthcare personnel and psychologists, to support parents in emotional and practical terms; the facilitation of the closeness of parents to children in extremely precarious clinical conditions; the relevant role of the associations of parents of sick children. Comments are made, in particular, about the innovative recommendations respectively relating to the adoption of care planning, the establishment, by law, of clinical ethics committees in paediatric hospitals and the limitation of recourse to courts—only as extrema ratio—in the event of irremediable disagreement between the medical team and the family members.
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spelling pubmed-77126702020-12-04 The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy Bolcato, Matteo Russo, Marianna Feola, Alessandro Della Pietra, Bruno Tettamanti, Camilla Bonsignore, Alessandro Ciliberti, Rosagemma Rodriguez, Daniele Aprile, Anna Healthcare (Basel) Commentary The motion of the Italian National Bioethics Committee entitled “Aggressive treatment or therapeutic obstinacy on young children with limited life expectancy” comprises a premise that rejects therapeutic obstinacy and makes 12 recommendations. Recommendation no. 1 states the general rules: it ascribes a cardinal role to a shared care plan, it supports pain management therapy and pain relief, it opposes ineffective and disproportionate clinical treatment and defensive medicine. The other recommendations are correlated to the enacting of a national law establishing clinical ethics committees in paediatric hospitals; participation of parents and their fiduciaries in the decision-making processes; recourse to courts only as extrema ratio in the event of irremediable disagreement between the medical team and the family members; accompaniment at the end of life also through continuous deep sedation combined with pain therapy; access to palliative care; the need to reinforce research on pain and suffering in children; clinical trials and research studies conducted in children; the training of doctors, healthcare personnel and psychologists, to support parents in emotional and practical terms; the facilitation of the closeness of parents to children in extremely precarious clinical conditions; the relevant role of the associations of parents of sick children. Comments are made, in particular, about the innovative recommendations respectively relating to the adoption of care planning, the establishment, by law, of clinical ethics committees in paediatric hospitals and the limitation of recourse to courts—only as extrema ratio—in the event of irremediable disagreement between the medical team and the family members. MDPI 2020-11-01 /pmc/articles/PMC7712670/ /pubmed/33139649 http://dx.doi.org/10.3390/healthcare8040448 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Commentary
Bolcato, Matteo
Russo, Marianna
Feola, Alessandro
Della Pietra, Bruno
Tettamanti, Camilla
Bonsignore, Alessandro
Ciliberti, Rosagemma
Rodriguez, Daniele
Aprile, Anna
The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy
title The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy
title_full The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy
title_fullStr The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy
title_full_unstemmed The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy
title_short The Motion of the Italian National Bioethics Committee on Aggressive Treatment towards Children with Limited Life Expectancy
title_sort motion of the italian national bioethics committee on aggressive treatment towards children with limited life expectancy
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712670/
https://www.ncbi.nlm.nih.gov/pubmed/33139649
http://dx.doi.org/10.3390/healthcare8040448
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