ArticleHealth care analysis : HCA : journal of health philosophy and policy2014
Deciding together? Best interests and shared decision-making in paediatric intensive care.
Article in Health care analysis : HCA : journal of health philosophy and policy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors affecting decision-making in children with complex care needs: a consensus approach to develop best practice in a UK children's hospital.BMJ paediatrics open · 2022Guideline
- Hoping Against Hope: Ethical Considerations when Trying Unproven Treatments for Seriously Ill Children.Asian bioethics review · 2025Article
- Shared decision-making in adolescent healthcare: a literature review of ethical considerations.European journal of pediatrics · 2024Review
- What does the best interests principle of the convention on the rights of the child mean for paediatric healthcare?European journal of pediatrics · 2022Review
- Decision-making experiences of health professionals in withdrawing treatment for children and young people: A qualitative study.Child: care, health and development · 2022Article
- Combining the best interest standard with shared decision-making in paediatrics-introducing the shared optimum approach based on a qualitative study.European journal of pediatrics · 2021Article
- Ethical Aspects of Mental Health Care for Lesbian, Gay, Bi-, Pan-, Asexual, and Transgender People: A Case-based Approach.The Yale journal of biology and medicine · 2020Review
- Legal and Ethical Aspects of 'Best Interests' Decision-Making for Medical Treatment of Companion Animals in the UK.Animals : an open access journal from MDPI · 2020Article
- Charlie Gard and the weight of parental rights to seek experimental treatment.Journal of medical ethics · 2018Article
- Physicians Perceptions of Shared Decision-Making in Neonatal and Pediatric Critical Care.The American journal of hospice & palliative care · 2018Article
- Ethical considerations about changing parental attitude towards end-of-life care in twins with lethal disease.Sudanese journal of paediatrics · 2018Article
- Reconciling Autonomy and Beneficence in Treatment Decision-Making for Companion Animal Patients.The Liverpool law review · 2018Article
- 'Best interests' in paediatric intensive care: an empirical ethics study.Archives of disease in childhood · 2017Article
- Decision-making at the borderline of viability: Who should decide and on what basis?Journal of paediatrics and child health · 2017Article
- Free Choice and Patient Best Interests.Health care analysis : HCA : journal of health philosophy and policy · 2016Article
- Dying well with reduced agency: a scoping review and thematic synthesis of the decision-making process in dementia, traumatic brain injury and frailty.BMC medical ethics · 2016Article
- Conflict escalation in paediatric services: findings from a qualitative study.Archives of disease in childhood · 2015Article
Corrections and comments
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Authors and funding
1 author.
Funding
Abstract
In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child's best interests, shared decision making is particularly questionable because agreement does not ensure moral validity. With reference to current common law and focusing on intensive care practice, this paper investigates what claims shared decision making may have to legitimacy in a paediatric intensive care setting. Drawing on key texts, I suggest these identify advantages to parents and clinicians but not to the child who is the subject of the decision. Without evidence that shared decision making increases the quality of the decision that is being made, it appears that a focus on the shared nature of a decision does not cohere with the principle that the best interests of the child should remain paramount. In the face of significant pressures toward the displacement of the child's interests in a shared decision, advantages of a shared decision to decisional quality require elucidation. Although a number of arguments of this nature may have potential, should no such advantages be demonstrable we have cause to revise our commitment to either shared decision making or the paramountcy of the child in these circumstances.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.