© 2005 BMJ Publishing Group & Royal College of Paediatrics and Child Health
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On both sides of the Atlantic, withdrawing life-sustaining treatment has received an enormous amount of publicity, mobilising both the public and politicians. Sadly, much of the "debate" has been carried to the courts. In May 2004, the College released the second edition of "Withholding or withdrawing life sustaining treatment in children: a framework for practice" (http://www.rcpch.ac.uk/publications/recent_publications/Witholding.pdf – last accessed April 20, 2005). The document provides a framework to guide management in individual cases. Five conditions are considered: the "brain dead child"; the "permanent vegative" state; the "no chance" situation; the "no purpose" situation; and the "unbearable" situation. As we push the limits of neonatal survival ever lower, and our technological wizardry advances in other areas, we are likely to be increasingly confronted by issues related to withdrawing life-sustaining treatment from children and adolescents.
Morris and colleagues from Birmingham Children’s Hospital are to be congratulated for performing a very valuable
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