SynthesisBMC palliative care2022
Physician decision-making process about withholding/withdrawing life-sustaining treatments in paediatric patients: a systematic review of qualitative evidence.
Synthesis in BMC palliative care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07401420 (Project Plan Physicians' Experiences of the Decision-making Process Regarding Decisions to Withhold/Discontinue Life-sustaining Treatment in Children Cared for in Intensive Care Units in Sweden. A Qualitative Study.), which is not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Project Plan Physicians' Experiences of the Decision-making Process Regarding Decisions to Withhold/Discontinue Life-sustaining Treatment in Children Cared for in Intensive Care Units in Sweden. A Qualitative Study.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Ethics and end-of-life in pediatric and neonatal ICUs: a systematic review of recommendations.BMC palliative care · 2025Pooled it
- Physicians' attitudes and experiences about withholding/withdrawing life-sustaining treatments in pediatrics: a systematic review of quantitative evidence.BMC palliative care · 2023Pooled it
- Medical assistance in dying in pediatrics: a retrospective case study of clinical interactions and implications for team training.Paediatrics & child health · 2026Article
- Nuanced Public Support for Rationing Treatments by Withdrawing and Withholding Due to Negative Reimbursement Decisions.Journal of bioethical inquiry · 2026Article
- Factors associated with survival of extremely preterm infants and development of a nomogram: a 9-year single-center study in China.Scientific reports · 2026Article
- A Double-Edged Sword: How Clinical Context Shapes Clinicians' Perceptions of Parental Religion in Paediatric Critical Care.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- How are agency and autonomy understood in children's palliative and end-of-life care?: A narrative review.Palliative care and social practice · 2026Review
- Barriers to and Facilitators of Pediatric Palliative Care in Mainland China, Hong Kong, and Taiwan: A Document Analysis.Children (Basel, Switzerland) · 2025Article
- Paediatric Palliative Care in Clinical Practice: Ethical Issues in Advance Care Planning and End-of-Life Decisions.Journal of evaluation in clinical practice · 2025Article
- Chinese and Belgian pediatricians' perspectives toward pediatric palliative care: an online survey.BMC palliative care · 2024Article
- Navigating the shadows: medical professionals' values and perspectives on end-of-life care within pediatric intensive care units in Croatia.Frontiers in pediatrics · 2024Article
- Article
- Pain perception and attitudes toward life-sustaining treatment in pediatric patients with disorders of consciousness: a survey of Chinese healthcare professionals.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith paediatric patients, deciding whether to withhold/withdraw life-sustaining treatments (LST) at the end of life is difficult and ethically sensitive. Little is understood about how and why physicians decide on withholding/withdrawing LST at the end of life in paediatric patients. In this study, we aimed to synthesise results from the literature on physicians' perceptions about decision-making when dealing with withholding/withdrawing life-sustaining treatments in paediatric patients.
methodsWe conducted a systematic review of empirical qualitative studies. Five electronic databases (Pubmed, Cinahl®, Embase®, Scopus®, Web of Science™) were exhaustively searched in order to identify articles published in English from inception through March 17, 2021. Analysis and synthesis were guided by the Qualitative Analysis Guide of Leuven.
resultsThirty publications met our criteria and were included for analysis. Overall, we found that physicians agreed to involve parents, and to a lesser extent, children in the decision-making process about withholding/withdrawing LST. Our analysis to identify conceptual schemes revealed that physicians divided their decision-making into three stages: (1) early preparation via advance care planning, (2) information giving and receiving, and (3) arriving at the final decision. Physicians considered advocating for the best interests of the child and of the parents as their major focus. We also identified moderating factors of decision-making, such as facilitators and barriers, specifically those related to physicians and parents that influenced physicians' decision-making.
conclusionsBy focusing on stakeholders, structure of the decision-making process, ethical values, and influencing factors, our analysis showed that physicians generally agreed to share the decision-making with parents and the child, especially for adolescents. Further research is required to better understand how to minimise the negative impact of barriers on the decision-making process (e.g., difficult involvement of children, lack of paediatric palliative care expertise, conflict with parents).
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What OpenQuestion holds
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.