Quand les parents s'opposent à l'arrêt des traitements : questionnement éthique autour de la judiciarisation en réanimation pédiatrique. Comparaison des modèles français, britannique et nord-américain

Abstract : Pediatric intensive care is a relatively recent specialty. However, as it sparkled enthusiasm thanks to the prowess it allowed, it has gradually given way to ethical questions. Limitation of Life-Sustaining Treatment (LLST) issues have become the subject of daily reflection in all Pediatric Intensive Care Units. Beyond the tragic outcome they may announce, LLST measures bring about possible disagreements if not conflicts between the parents and the medical and paramedical team as illustrated by Henri's story. The ethical issue raised by this clinical case allows for the presentation of three models of decision-making processes. In the French model, the doctor is the legal decision-maker, but in practice, he submits his decision to parental approval. In the British model, the doctor and the parents are legal co-decision-makers, the judge becoming, if necessary, the supreme decision-maker. Finally, in the North American model, parents take all responsibility for making the decision. These conflict situations are therefore not treated in the same way in every country, which highlights their difference in understanding the law as in their mindset. The principle of the child’s best interests being reflected in all three models underlines both the strength and the ambiguity of this ethical and legal point of reference.
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Master Thesis
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Delphine Brown. Quand les parents s'opposent à l'arrêt des traitements : questionnement éthique autour de la judiciarisation en réanimation pédiatrique. Comparaison des modèles français, britannique et nord-américain. Ethique. 2018. ⟨dumas-02094549⟩

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