Nurses as withdrawers of life sustaining treatment in paediatric intensive care

Giles Birchley, Bev Cejer

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)
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Background: Withdrawal of life saving medical treatment is a common modality of death within UK paediatric intensive care units (PICUs). The majority of treatment withdrawals are carried out by medical staff, usually the consultant in charge of the child's care.

Aim: To assess current practice of experienced PICU nurses performing the key tasks in treatment withdrawal once the decision has been made and its legal implications.

Design and Method: The study was divided into three chronologically successive phases. In phase 1, a 12-item paper survey was circulated to nursing staff on a UK PICU. In phase 2, a three-item survey regarding current practice was sent to nurse managers on 22 UK PICUs. In phase 3, analysis of legal issues related to nurses withdrawing treatment was undertaken.

Results: Poor response rates to both surveys limited their value; however, they may stimulate discussion of the issue within nursing. Phase 1 received 15 of 100 (15%) responses; open-ended questions highlighted practitioner concerns. Eight of twenty-two (36%) responses for phase 2 showed no consistent approach to the issue nationally. Legal analysis indicated that the law was untested in this area and nurses would be advised to withdraw treatment only if following a documented medical plan. Risks of legal and regulatory action could be reduced by formulating clear guidelines.

Conclusion: PICU nurses could potentially enact withdrawal, but discussion is needed to resolve uncertainties.

Relevance to Clinical Practice: National Guidelines from within the PICU community could assist nurses participating in treatment withdrawal.

Original languageEnglish
Pages (from-to)43-51
Number of pages9
JournalNursing in Critical Care
Issue number1
Early online date5 Oct 2012
Publication statusPublished - 4 Jan 2013

Bibliographical note

© 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.


  • Attitude of Health Personnel
  • Ethics, Nursing
  • Great Britain
  • Humans
  • Intensive Care Units, Pediatric
  • Nurse's Role
  • Questionnaires
  • Withholding Treatment
  • Ethical issues in nursing
  • Intensive care nursing
  • Law
  • Practice development
  • Paediatric intensive care
  • Withholding/withdrawing treatment


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