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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Decisions concerning potentially life-sustaining treatments in paediatric nephrology: a multicentre study in French-speaking countries</title><author><name sortKey="Fauriel, Isabelle" sort="Fauriel, Isabelle" uniqKey="Fauriel I" first="Isabelle" last="Fauriel">Isabelle Fauriel</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Moutel, Gregoire" sort="Moutel, Gregoire" uniqKey="Moutel G" first="Gregoire" last="Moutel">Gregoire Moutel</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Moutard, Marie Laure" sort="Moutard, Marie Laure" uniqKey="Moutard M" first="Marie-Laure" last="Moutard">Marie-Laure Moutard</name><affiliation><nlm:aff id="A2">Service de neuropédiatrie<institution>GHU Ouest</institution><addr-line>Hôpîtal Saint-Vincent de Paul
74-82, avenue Denfert-Rochereau
75674 Paris Cedex 14,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Montuclard, Luc" sort="Montuclard, Luc" uniqKey="Montuclard L" first="Luc" last="Montuclard">Luc Montuclard</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Duchange, Nathalie" sort="Duchange, Nathalie" uniqKey="Duchange N" first="Nathalie" last="Duchange">Nathalie Duchange</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Callies, Ingrid" sort="Callies, Ingrid" uniqKey="Callies I" first="Ingrid" last="Callies">Ingrid Callies</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Francois, Irene" sort="Francois, Irene" uniqKey="Francois I" first="Irene" last="Francois">Irene Francois</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Cochat, Pierre" sort="Cochat, Pierre" uniqKey="Cochat P" first="Pierre" last="Cochat">Pierre Cochat</name><affiliation><nlm:aff id="A3">Pédiatrie<institution>CHU de Lyon</institution><addr-line>Hôpital Edouard Herriot
5 Place d'Arsonval - 69003 Lyon,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Herve, Christian" sort="Herve, Christian" uniqKey="Herve C" first="Christian" last="Herve">Christian Herve</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">14993486</idno><idno type="pmc">1890006</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1890006</idno><idno type="RBID">PMC:1890006</idno><idno type="doi">10.1093/ndt/gfh100</idno><date when="2004">2004</date><idno type="wicri:Area/PubMedCentral/Corpus">000052</idno><idno type="wicri:explorRef" wicri:stream="PubMedCentral" wicri:step="Corpus" wicri:corpus="PMC">000052</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Decisions concerning potentially life-sustaining treatments in paediatric nephrology: a multicentre study in French-speaking countries</title><author><name sortKey="Fauriel, Isabelle" sort="Fauriel, Isabelle" uniqKey="Fauriel I" first="Isabelle" last="Fauriel">Isabelle Fauriel</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Moutel, Gregoire" sort="Moutel, Gregoire" uniqKey="Moutel G" first="Gregoire" last="Moutel">Gregoire Moutel</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Moutard, Marie Laure" sort="Moutard, Marie Laure" uniqKey="Moutard M" first="Marie-Laure" last="Moutard">Marie-Laure Moutard</name><affiliation><nlm:aff id="A2">Service de neuropédiatrie<institution>GHU Ouest</institution><addr-line>Hôpîtal Saint-Vincent de Paul
74-82, avenue Denfert-Rochereau
75674 Paris Cedex 14,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Montuclard, Luc" sort="Montuclard, Luc" uniqKey="Montuclard L" first="Luc" last="Montuclard">Luc Montuclard</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Duchange, Nathalie" sort="Duchange, Nathalie" uniqKey="Duchange N" first="Nathalie" last="Duchange">Nathalie Duchange</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Callies, Ingrid" sort="Callies, Ingrid" uniqKey="Callies I" first="Ingrid" last="Callies">Ingrid Callies</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Francois, Irene" sort="Francois, Irene" uniqKey="Francois I" first="Irene" last="Francois">Irene Francois</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Cochat, Pierre" sort="Cochat, Pierre" uniqKey="Cochat P" first="Pierre" last="Cochat">Pierre Cochat</name><affiliation><nlm:aff id="A3">Pédiatrie<institution>CHU de Lyon</institution><addr-line>Hôpital Edouard Herriot
5 Place d'Arsonval - 69003 Lyon,FR</addr-line></nlm:aff></affiliation></author><author><name sortKey="Herve, Christian" sort="Herve, Christian" uniqKey="Herve C" first="Christian" last="Herve">Christian Herve</name><affiliation><nlm:aff id="A1">Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></nlm:aff></affiliation></author></analytic><series><title level="j">Nephrology, Dialysis, Transplantation </title><idno type="ISSN">0931-0509</idno><idno type="eISSN">1460-2385</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p>Few studies have looked at the way in which decisions to withhold or to withdraw potential life-sustaining treatments (LST) are taken in paediatric nephrology. The aim of this work was to evaluate such practices in all nephrology centres in French-speaking European countries, so that guidelines could be drawn up and discussed by professionals.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p>Semi-directed interviews were used to question health-care professionals prospectively. We also retrospectively analysed the medical files of all children (n= 50) for whom a decision to withhold or to withdraw LST had been taken in the last five years. The doctors (n=31) who had been involved in the decision-making process were interviewed.</p></sec><sec id="S3"><title>Results</title><p>All 31 of the French-speaking paediatric nephrology centres in Europe were included in this study. Eighteen of these centres had made decisions about whether to withhold or to withdraw LST in the previous five years. Subsequent quality of life, based on long-term living conditions, was the principal criterion used to make decisions. Criteria affecting relational aspects of life and the child’s prognosis were also considered. The decision-making processes (DMP) were not always collective even though interactions between doctors and the rest of the medical team seemed to be a key element. The parents’ involvement in the DMP differed between centres.</p></sec><sec id="S4"><title>Conclusions</title><p>The criteria used to decide whether to withhold or to withdraw LST are not standardised and no specific guidelines have been established.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Nephrol Dial Transplant</journal-id><journal-title>Nephrology, Dialysis, Transplantation </journal-title><issn pub-type="ppub">0931-0509</issn><issn pub-type="epub">1460-2385</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">14993486</article-id><article-id pub-id-type="pmc">1890006</article-id><article-id pub-id-type="manuscript">HALMS90562</article-id><article-id pub-id-type="doi">10.1093/ndt/gfh100</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject><subj-group subj-group-type="subrepository"><subject>INSERM Subrepository</subject></subj-group></subj-group></article-categories><title-group><article-title>Decisions concerning potentially life-sustaining treatments in paediatric nephrology: a multicentre study in French-speaking countries</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Fauriel</surname><given-names>Isabelle</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Moutel</surname><given-names>Gregoire</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Moutard</surname><given-names>Marie-Laure</given-names></name><xref rid="A2" ref-type="aff">2</xref></contrib><contrib contrib-type="author"><name><surname>Montuclard</surname><given-names>Luc</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Duchange</surname><given-names>Nathalie</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Callies</surname><given-names>Ingrid</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Francois</surname><given-names>Irene</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Cochat</surname><given-names>Pierre</given-names></name><xref rid="A3" ref-type="aff">3</xref></contrib><contrib contrib-type="author"><name><surname>Herve</surname><given-names>Christian</given-names></name><xref rid="A1" ref-type="aff">1</xref><xref rid="FN1" ref-type="author-notes">*</xref></contrib></contrib-group><aff id="A1"><label>1</label>Laboratoire d'Ethique Médicale, de Droit de la Santé et de Santé Publique<institution>Institut international de recherche en éthique biomédicale</institution><institution>Université René Descartes - Paris V</institution><addr-line>156 rue de Vaugirard
Paris 75015,FR</addr-line></aff><aff id="A2"><label>2</label>Service de neuropédiatrie<institution>GHU Ouest</institution><addr-line>Hôpîtal Saint-Vincent de Paul
74-82, avenue Denfert-Rochereau
75674 Paris Cedex 14,FR</addr-line></aff><aff id="A3"><label>3</label>Pédiatrie<institution>CHU de Lyon</institution><addr-line>Hôpital Edouard Herriot
5 Place d'Arsonval - 69003 Lyon,FR</addr-line></aff><author-notes><corresp id="FN1">* Correspondence should be adressed to: Christian Hervé <email>herve@necker.fr</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2004</year></pub-date><pub-date pub-type="epub"><day>19</day><month>2</month><year>2004</year></pub-date><pub-date pub-type="pmc-release"><day>14</day><month>6</month><year>2007</year></pub-date><volume>19</volume><issue>5</issue><fpage>1252</fpage><lpage>1257</lpage><abstract><sec id="S1"><title>Background</title><p>Few studies have looked at the way in which decisions to withhold or to withdraw potential life-sustaining treatments (LST) are taken in paediatric nephrology. The aim of this work was to evaluate such practices in all nephrology centres in French-speaking European countries, so that guidelines could be drawn up and discussed by professionals.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p>Semi-directed interviews were used to question health-care professionals prospectively. We also retrospectively analysed the medical files of all children (n= 50) for whom a decision to withhold or to withdraw LST had been taken in the last five years. The doctors (n=31) who had been involved in the decision-making process were interviewed.</p></sec><sec id="S3"><title>Results</title><p>All 31 of the French-speaking paediatric nephrology centres in Europe were included in this study. Eighteen of these centres had made decisions about whether to withhold or to withdraw LST in the previous five years. Subsequent quality of life, based on long-term living conditions, was the principal criterion used to make decisions. Criteria affecting relational aspects of life and the child’s prognosis were also considered. The decision-making processes (DMP) were not always collective even though interactions between doctors and the rest of the medical team seemed to be a key element. The parents’ involvement in the DMP differed between centres.</p></sec><sec id="S4"><title>Conclusions</title><p>The criteria used to decide whether to withhold or to withdraw LST are not standardised and no specific guidelines have been established.</p></sec></abstract><kwd-group kwd-group-type="MESH"><kwd>Child</kwd><kwd>Child, Preschool</kwd><kwd>France</kwd><kwd>Humans</kwd><kwd>Kidney Diseases</kwd><kwd>classification</kwd><kwd>therapy</kwd><kwd>Medical Records</kwd><kwd>Nephrology</kwd><kwd>trends</kwd><kwd>Quality of Life</kwd><kwd>Renal Replacement Therapy</kwd><kwd>ethics</kwd><kwd>statistics & numerical data</kwd></kwd-group><kwd-group kwd-group-type="author"><kwd>dialysis</kwd><kwd>ethics</kwd><kwd>life-sustaining treatments</kwd><kwd>nephrology</kwd><kwd>paediatric</kwd><kwd>treatment withholding or withdrawal</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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