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ArticleActa anaesthesiologica Scandinavica2026

Swedish Intensive Care Physicians' Attitudes Towards Withholding or Withdrawing Life-Sustaining Treatment in Critically Ill Children.

Maria Ahlerup, Johan Malmgren, Albert Gyllencreutz Castellheim, Johan Holmén, Ola Ingemansson, Lars Sandman, Helena Odenstedt Hergès, Linda Block

Abstract read
In one paragraph

Article in Acta anaesthesiologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Maria AhlerupDepartment of Anaesthesiology and Intensive Care, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0009-0002-2706-4525
Johan MalmgrenDepartment of Anaesthesiology and Intensive Care, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0001-7563-0849
Albert Gyllencreutz CastellheimDepartment of Anaesthesiology and Intensive Care, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0001-6387-8855
Johan HolménDepartment of Anaesthesiology and Intensive Care, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Ola IngemanssonDepartment of Pediatric Anaesthesia/Surgical Operations/Intensive Care, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
Lars SandmanDepartment of Health, Medicine and Caring Sciences, The National Centre for Priorities in Health, Linköping University, Linköping, Sweden.
Helena Odenstedt HergèsDepartment of Anaesthesiology and Intensive Care, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Linda BlockDepartment of Anaesthesiology and Intensive Care, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-7736-0093

Funding

The Swedish governmental funding of clinical research (ALF) ALFGBG-1028656Wilhelm and Martina Lundgren, Science Fund 2024-SA-4447Wilhelm and Martina Lundgren, Science Fund 2025-SA-4848
6 · The paper itself

Abstract

backgroundDecisions to withhold or withdraw life-sustaining treatments for critically ill children are challenging. This study aims to identify Swedish intensivists' attitudes, values and experiences towards the decision-making process concerning withholding or withdrawal of life-sustaining treatment in critically ill children.

methodsThe nine intensive care units in Sweden that treated more than 10 children for more than 48 h during 2023 were approached. A web-based questionnaire on attitudes and experiences on end-of-life decision-making in critically ill children was distributed to the 360 physicians employed at the above-mentioned intensive care units. The results were analysed descriptively.

resultsFifty-five answers were retrieved. The participating physicians were experienced, 93% having personal experience with end-of-life decision-making in children. The main findings were that the child's wishes were considered important or very important by 93% of respondents. The guardians' wishes were considered important or very important by 82% of respondents. Seventy-three percent of physicians considered it ethically acceptable to withdraw life-sustaining treatment against the patients' and guardians' wishes. To continue life-sustaining treatment without the patient's and guardian's consent was considered ethically acceptable by 26% of participants.

conclusionsThis study demonstrated that Swedish intensivists share common attitudes and values regarding most issues related to end-of-life decisions in critically ill children. However, there is variability in attitudes concerning patients' and guardians' wishes. Further studies concerning end-of-life decisions in critically ill children within a Nordic context are warranted. EDITORIAL COMMENT: This survey study presents a sampling of views on pediatric intensive care withholding or withdrawing of treatment and from specialist physicians in one Nordic country.

Indexed as

Attitude of Health PersonnelCritical CareCritical IllnessLife Support CarePhysiciansWithholding TreatmentAdultChildFemaleHumansMaleSurveys and QuestionnairesSweden

Identifiers

PMID42138470
PMCPMC13178199

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.